Two Cases of Stercoral Perforation in the Stoma Limb Early after Colostomy

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  • Sato Go
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center
  • Ikenaga Masakazu
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center
  • Ueda Masami
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center
  • Ohta Katsuya
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center
  • Tsuda Yujiro
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center
  • Nakashima Shinsuke
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center
  • Matsuyama Jin
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center
  • Nakagawa Tomo
    Department of Surgery, Kinan Hospital
  • Endo Shunji
    Department of Surgery, Yao Municipal Hospital
  • Yamada Terumasa
    Department of Gastroenterological Surgery, Higashiosaka City Medical Center

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Other Title
  • 人工肛門造設後早期に宿便による人工肛門脚部穿孔を生じた２例

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<p>Case 1 was an 87-year-old woman who underwent Hartmann’s operation for stercoral perforation. On the sixth postoperative day, she was diagnosed as having perforation of the colon close to the colostomy due to stool that remained in the oral intestine, and a colectomy and colostomy were performed. She died of aspiration pneumonia 44 days after the first operation. Case 2 was an 87-year-old man who had laparoscopic-assisted rectal resection for anal canal cancer. On the second postoperative day, emergency surgery was performed for stercoral perforation of the stoma limb. He was transferred to another hospital 85 days after the first operation. Stercoral perforation after colostomy is rare. This is the first report in Japan of cases where perforation due to fecal impaction that remained after the initial surgery has occurred as in our cases. At the time of colostomy construction, attention is not given to the fecal mass of the oral intestinal tract compared to when performing intestinal anastomosis, but if there is a large amount of stool in the remaining intestinal tract, removing as much as possible of the stool is important.</p>

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