Sigmoid colon perforation caused by three living loaches inserted into anus: a case report

Abstract BACKGROUND Colorectal perforation are common surgical emergencies. Yet perforation caused by living animals has not been reported with no record found on Medline. CASE PRESENTATION A 47-year-old male arrived at our surgical emergency room for "severe abdominal pain with itchy rash for 5 hours", who explained that "three big living loaches" had been squeezed into the anus 1 hour before the onset of symptoms. Thorough physical and auxiliary examinations suggested lower gastrointestinal perforation. After prompt anti-shock, anti-allergy, analgesia and gastrointestinal decompression, we performed exploratory laparotomy, sigmoid colon repair and double-lacuna ileostomy. The patient underwent uneventful postoperative recovery and was discharged on the 10th day after surgery. CONCLUSIONS CT examination is critical for diagnosing colorectal perforation caused by living animals (3 loaches as reported in our case). Specifically, due attention should be given to the serious allergic reaction induced by exogenous organisms entering the abdominal cavity. Surgery should be performed as soon as possible to fundamentally address the allergic shock. As to colorectal perforation caused by multiple living organisms, considering the restricted condition for thorough exploration during emergency surgery (particularly the exploration of the posterior wall of the colon), colostomy should be selected with caution.

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A case of sigmoid colon perforation presenting with pneumomediastinum

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz359 ◽

2019 ◽

Vol 2019 (12) ◽

Author(s):

Yukihito Kuroda ◽

Katsuji Hisakura ◽

Yoshimasa Akashi ◽

Tsuyoshi Enomoto ◽

Tatsuya Oda

Keyword(s):

Computed Tomography ◽

Sigmoid Colon ◽

Gastrointestinal Endoscopy ◽

Abdominal Cavity ◽

Colon Perforation ◽

Upper Gastrointestinal Endoscopy ◽

Free Air ◽

Oral Steroids ◽

Sigmoid Colon Perforation ◽

Upper Gastrointestinal

Abstract A 62-year-old woman had developed polymyositis 12 years previously and had taken oral steroids. Chest and abdominal computed tomography showed pneumomediastinum and free air in the abdominal cavity. Although a colon perforation was suspected, the perforation site could not be identified on the image. In addition, a diagnosis of oesophageal rupture could not be excluded from the findings of pneumomediastinum. After general anaesthesia, an upper gastrointestinal endoscopy was performed before surgery. Because there was no obvious perforation in the oesophagus, a laparotomy approach was used. A perforation was found on the mesentery side of the sigmoid colon, and a perforation of the sigmoid colon’s diverticulum towards the mesentery was diagnosed. A Hartmann’s procedure was performed. Colon perforations are rarely associated with pneumomediastinum. Preoperative endoscopy is useful to help diagnose and determine the surgical procedure if an obvious perforation cannot be identified.

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Delayed Post-Barium Enema Sigmoid Colon Perforation Due to Squamous Cell Carcinoma Invasion from an Unknown Primary Source

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.44.78 ◽

2011 ◽

Vol 44 (1) ◽

pp. 78-83 ◽

Cited By ~ 1

Author(s):

Tomoki Yamano ◽

Chikao Yutani ◽

Isao Arai ◽

Toshiaki Takada

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Sigmoid Colon ◽

Barium Enema ◽

Squamous Cell ◽

Primary Source ◽

Colon Perforation ◽

Unknown Primary ◽

Sigmoid Colon Perforation

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Sigmoid Colon Perforation Occurred in 12 years after Renal Transplantation

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.39.620 ◽

2006 ◽

Vol 39 (5) ◽

pp. 620-625 ◽

Cited By ~ 2

Author(s):

Hiroaki Takeshita ◽

Takashi Tsuji ◽

Terumitsu Sawai ◽

Shigekazu Hidaka ◽

Shinichi Shibazaki ◽

...

Keyword(s):

Renal Transplantation ◽

Sigmoid Colon ◽

Colon Perforation ◽

Sigmoid Colon Perforation

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Transmurally migrated gossypiboma rarely posing as surgical site infection: a case report and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20204168 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3500

Author(s):

Amrita Gaurav ◽

Juhi Mishra ◽

Om Kumari ◽

Kavita Khoiwal ◽

Farhanul Huda ◽

...

Keyword(s):

Caesarean Section ◽

Surgical Site Infection ◽

Sigmoid Colon ◽

Primary Repair ◽

Wound Dehiscence ◽

Colon Perforation ◽

Site Infection ◽

Surgical Sponge ◽

Ileal Loop ◽

Sigmoid Colon Perforation

The term gossypiboma is used to describe a retained surgical sponge or gauge after surgery. The clinical features range from being asymptomatic to frank bowel obstruction, perforation and peritonitis. Radiological modalities also do not provide a definite diagnosis. We report a case of a 30-year-old lady who presented to the emergency room with recurrent surgical site infection. She had a history of caesarean section 5 months ago. Following the caesarean section, she developed superficial wound dehiscence which was re-sutured. At the present facility, the lady underwent Computed tomography (CT) scan and was suspected to have a foreign body around the gut. She was planned for an exploratory laparotomy. Upon laparotomy, a large thick-walled ileal loop with some unusual intra luminal mass was found. Dense adhesions were present between the ileal loop and sigmoid colon. Adhesiolysis led to an iatrogenic sigmoid colon perforation, around 2 cm length. On incision over the ileal loop, surgical sponge was retrieved. Ileal loop was resected along with perforated site with end-to-end ileo-ileal anastomosis was done. Primary repair of sigmoid colon perforation was done. Patient was stable in postoperative period. Although rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting with recurrent surgical site infection.

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Early-onset sigmoid colon perforation during concurrent chemoradiation in a patient with cervical cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200403000-00030 ◽

2004 ◽

Vol 14 (2) ◽

pp. 381-383

Author(s):

H. Lin ◽

C.-L. Chang ◽

E.-Y. Huang ◽

C.-C. Changchien

Keyword(s):

Cervical Cancer ◽

Sigmoid Colon ◽

Concurrent Chemoradiotherapy ◽

Tissue Injury ◽

Gynecological Cancer ◽

Good Condition ◽

External Beam Radiation ◽

Colon Perforation ◽

Beam Radiation ◽

Sigmoid Colon Perforation

Radiation-induced colon perforation is a rare adverse effect caused by vascular and connective tissue injury to the rectosigmoid colon. It usually occurs a few months to years after radiotherapy for gynecological cancer. Herein, we present a patient who developed sigmoid colon perforation during concurrent chemoradiotherapy for cervical cancer. The patient was a 64-year-old clinical stage IIB woman who received concurrent chemoradiotherapy as a standard treatment. The chemotherapeutic protocol was cisplatin 50 mg/m2 and 5-fluorouracil 4000 mg, starting together with radiotherapy. After the completion of external beam radiation for 4500 cGy, the patient developed sigmoid colon perforation presenting with fecal peritoneum and sepsis. An emergency end ileostomy with resection of entire sigmoid colon was performed and the patient was discharged 3 months later in good condition. Clinicians must be highly suspicious of serious bowel perforation, even if the full dose of radiation has not been completed. Whether or not the chemotherapy was the trigger factor is in need of further clarification.

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