A Case of Stercoral Perforation of the Sigmoid Colon in a Hemodialysis Patient

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  • 血液透析患者に発症した宿便性S状結腸穿孔の1救命例
  • ケツエキ トウセキ カンジャ ニ ハッショウ シタ シュクベンセイ Sジョウ ケッチョウ センコウ ノ 1 キュウメイレイ

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Abstract

<p>We report a case of stercoral perforation of the sigmoid colon. An 80–year–old woman undergoing maintenance hemodialysis therapy for chronic renal failure was admitted to our hospital with a history of lower abdominal pain and fever. Computed tomography (CT) revealed a large amount of fecal material in the sigmoid colon and free air. Based on the findings, the patient was diagnosed as having a perforation of the sigmoid colon, and taken up for emergency surgery. During the surgery, a 4–cm perforation was identified in the sigmoid colon, and fecal material was detected outside the intestinal tract. After cleaning out the intestinal lumen of the stool to the extent possible, the segment of the sigmoid colon containing the perforation was excised, and colostomy was performed. After surgery, the patient underwent polymyxin B–immobilized fiber column direct hemoperfusion (PMX–DHP). The postoperative course was uneventful, without any complications, and the patient was discharged from the hospital on the 37th postoperative day. In the resected specimen, there were no specific histopathological findings at the site of perforation, and the diagnosis of stercoral perforation of the sigmoid colon was confirmed. Stercoral perforation of the colon is relatively rare, and we present the case herein, with a review of the relevant literature.</p>

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