Presentation
A 67-year-old man presented with abdominal pain, sub-occlusion, left groin mass, left groin, and lower limb pain during walking, negative Blumberg sign. [ncbi.nlm.nih.gov]
Entire Body System
- Sepsis
Work-up for sepsis was suspicious for perforated viscus. An exploratory laparotomy revealed a perforated transverse colon with gross spillage of succus. [ncbi.nlm.nih.gov]
- Fever
Opportunistic infection should always be kept in mind in SLE patients presenting with fever. [ncbi.nlm.nih.gov]
Typhoid fever-microbiological aspects. Nig Postgrad Med J 1994;1:39-43. 14. Grange A. A review of typhoid fever in Africa. Nig P Med J 1994;1:34-7. 15. Maiorini E, Lopez EL, Marrow AL. [dx.doi.org]
Clinical case A 17-year-old female who was admitted with low back pain, limiting flexion of the thigh, fever, vaginal discharge, abdominal pain and weight loss. [elsevier.es]
Presenting signs and symptoms of bowel perforation in 24 patients treated with bevacizumab. 12 *Specific signs included mental status changes, fever, tachycardia ( > 120 beats per minute), and leukocytosis. [jaoa.org]
- Inflammation
However, in some cases, fecal diversion is reported to adversely affect the inflammation of the diverted bowel, and it is this unusual complication of Crohn's disease that we discuss here. [ncbi.nlm.nih.gov]
Diverticulitis is inflammation or infection (or both) in a balloon-like pouch called a diverticulum in the intestine. [honorhealth.com]
Although several studies reported the effects of inflammation in the local tumor environment [9,10,11], the effect of sealed-off perforation on local inflammation has not been sufficiently addressed. [wjso.biomedcentral.com]
Histological findings in ipilimumab-related colitis can range from normal architecture to severe acute inflammation [5]. [cureus.com]
- Anemia
A diagnostic colonoscopy was requested due to her anemia, and colonoscopy revealed a few sessile polyps in sigmoid and descending colon. [scielo.br]
Presenting symptoms include non-specific findings such as abdominal pain, decreased appetite, weight loss and anemia [3]. [edoriumjournals.com]
Your blood tests also may show signs of anemia due to bleeding. Smaller perforations may be harder to diagnose, and that may mean more time and imaging tests. [verywellhealth.com]
Case Reports Case 1: Rectal Perforation due to a Rectal Catheter An 83-year-old man with a medical history of lumbar canal stenosis was referred to Ishikari Hospital, Hokkaido, Japan, with anemia (hemoglobin 10.2 mg/dl). [karger.com]
- Inguinal Hernia
External forces that may appear trivial in the setting of blunt abdominal trauma can cause significant hollow viscus injury when applied directly to an inguinal hernia. [ncbi.nlm.nih.gov]
This 78-year-old patient also had a left inguinal hernia. The other two were female (77 and 78 years, respectively), one with a history of a caesarean section and one with a history of a total abdominal hysterectomy. [labome.org]
Any cause of colonic obstruction, for example obstructive CRC or inguinal hernias, and specifically left-sided hernias containing the sigmoid colon, may predispose a patient to perforation due to overdistension [ 12, 16 ]. [karger.com]
Rare complications Rare complications of colonoscopy with and without polypectomy have been reported and include infections related to instrument cleanliness [ 76 ] incarceration of the colonoscope in an inguinal hernia [ 77 ], splenic injury during colonoscopy [intechopen.com]
Gastrointestinal
- Overeating
The primary endpoint of this observational, retrospective study analyses surgical technique chosen by the colorectal specialized (CS) or general surgeon (GS) and changes over time. [ncbi.nlm.nih.gov]
- Acute Abdomen
Our patient presented acutely unwell and her symptoms were more suggestive of pyelonephritis or diverticulitis. We therefore report an unusual cause of acute abdomen. [ncbi.nlm.nih.gov]
This should be included in the differential diagnosis of acute abdomen because of the extremely high mortality rates if not diagnosed on time. [ijpmonline.org]
- Severe Abdominal Pain
The patient developed severe abdominal pain two hours after the examination. Abdominal X-ray and computed tomography showed massive free air. Immediate laparotomy was performed for the intestinal perforation. [dovepress.com]
This causes a severe infection called peritonitis. Symptoms may include: Severe abdominal pain Chills Fever Nausea Vomiting Shock X-rays of the chest or abdomen may show air in the abdominal cavity. This is called free air. It is a sign of a tear. [nlm.nih.gov]
A perforation may be caused by: Direct trauma to the wall of the intestine Increased pressure against a weakened area of intestine Breakdown of intestinal wall by infection or disease Symptoms may include: Severe abdominal pain, may start shortly before [health.cvs.com]
- Abdominal Distension
They may also suffer from abdominal distension due to the penetration of gas through the perforation and the entry of this gas into the abdomen. A perforated colon can be diagnosed clinically or radiologically. [labome.org]
Abdominal examination was significant for diminished bowel sounds, diffuse abdominal distension, rigidity, and tenderness with light palpation. [mdedge.com]
:: Case report A 3.2 kg, new born, mate child was referred after 24 hours, for increasing abdominal distension. The antenatal as well as perinatal course was normal and uncomplicated. [jpgmonline.com]
A 67-year-old female was admitted in the emergency department with a history of constipation for 5 days, abdominal pain, and increasing abdominal distension. [ijri.org]
- Abdominal Tenderness
After the examination, the patient did not complain of abdominal pain, and his vital signs were stable. Physical examination revealed no lower abdominal tenderness on palpation. [karger.com]
He had diffuse abdominal tenderness to deep palpation. Initial labs, especially the basic metabolic panel, showed hypokalemia (3.3 meq/L), hyponatremia (128 meq/L), and mild metabolic alkalosis (bicarbonate 28 meq/L). [cureus.com]
On physical examination, all patients showed signs of abdominal tenderness, while signs of peritoneal irritation (e.g. muscular guarding, rebound tenderness) were recorded in only half of the patients. [tropicalgastro.com]
Cardiovascular
- Tachycardia
Presenting signs and symptoms of bowel perforation in 24 patients treated with bevacizumab. 12 *Specific signs included mental status changes, fever, tachycardia ( > 120 beats per minute), and leukocytosis. [jaoa.org]
Her electrocardiogram showed sinus tachycardia with a rate of 154 beats/min, a QTc within normal limits, and no ST elevations or depressions. [mdedge.com]
Nausea and vomiting, tachycardia, hypotension, fevers, chills, sweats, confusion, and decreased urinary output are common. Treatment Surgical treatment is necessary. [medical-dictionary.thefreedictionary.com]
- Hypertension
We report two CS patients, Case 1: 31-year old male with hypertension (HTN) and diabetes mellitus type 2 (DM2) presented with abdominal pain and hematochezia. [endocrine.org]
CASE REPORT A 73-year-old man, with previous history of diabetes mellitus, arterial hypertension and coronary heart disease, has been admitted for iatrogenic colonic perforation. [ghrnet.org]
The past medical history was also significant for chronic constipation, neuralgia, and hypertension. [cureus.com]
The patient's medical history included, arterial hypertension treated with nifedipine 20 mg/tid, dyslipidaemia treated with atorvastatin 10 mg/daily. [elsevier.es]
CASE REPORT A 65-year-old Caucasian male with a history of hepatitis C virus (HCV) infection, chronic kidney disease, hypertension, on anticoagulation presented to his primary care physician with chronic abdominal pain. [edoriumjournals.com]
Psychiatrical
- Suggestibility
This case suggests that hypermagnesemia should be considered in renal failure patients as this can result in life-threatening events despite prompt treatment. [ncbi.nlm.nih.gov]
Results from two retrospective studies recently published in Gastrointestinal Endoscopy present differing conclusions on the effectiveness of through-the-scope clips for endoscopic closure of iatrogenic colonic perforations, one of which suggests that [healio.com]
Urogenital
- Incontinence
Physiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse. Br J Surg. Pagina 213 - Gardner, EJ (1951). [books.google.ro]
The symptoms may be those of inability to evacuate, but not infrequently and paradoxically patients will present with faecal incontinence. [surgwiki.com]
A double-balloon catheter was thought to be necessary for the examination of the first patient reported here because based on the patient's physical condition associated with advanced age, incontinence for gas insufflation was anticipated. [karger.com]
- Cesarean Section
We document a previously unreported case of a 37-year-old female in whom APS was first manifested by infarction and cecal perforation following cesarean section. [ncbi.nlm.nih.gov]
Case Presentation We present the case of a female patient, nursing infant, delivered by cesarean section due to cephalopelvic disproportion with 3,300 kg birth weight, breast-fed and presented with constipation from birth. [jpss.eu]
Workup
Serum carcinoembryonic antigen and carbohydrate antigen 19-9 values were not measured during his initial workup. [edoriumjournals.com]
Workup revealed a synchronous colonic perforation. After multidisciplinary discussion she was managed with total colectomy and end ileostomy. [omicsonline.org]
X-Ray
- Pneumoperitoneum
[…] volume of free fluid and less pneumoperitoneum the presence of pneumoperitoneum in the periportal region is also suggestive of upper GI perforation 6 Promoted articles (advertising) [radiopaedia.org]
Abdominal computed tomography scan showed extensive pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum, and leftsided pneumothorax. [ncbi.nlm.nih.gov]
In images she has a great pneumoperitoneum. At laparotomy it was not found any injury to the colon. She has a good post-operative evolution. Respective literature review is done. Palabras clave : Pneumoperitoneum; Colonoscopy; Peritonitis. [scielo.conicyt.cl]
Pneumoperitoneum due to insufflation of gas at laparoscopy has identical appearances. [radiologymasterclass.co.uk]
Colonoscopy
- Colitis
OBJECTIVE: Collagenous colitis is an increasingly diagnosed clinical and pathological variant of microscopic colitis, mainly affecting middle-aged and elderly women; herein we review the literature for a rare complication (colonic perforation) and the [ncbi.nlm.nih.gov]
Keywords Colonic perforation; Ulcerative colitis; End ileostomy Introduction Inflammatory bowel disease (IBD) encompasses Crohn’s disease (CD) and Ulcerative Colitis (UC). [omicsonline.org]
Treatment
Self-expandable stents are widely available for the treatment of perforation of the gastrointestinal tract. [ncbi.nlm.nih.gov]
Prognosis
This study is the first to assess the difference in oncological prognosis between sealed-off perforation and free perforation. [wjso.biomedcentral.com]
High-anesthetic risk patients with colonic perforation have a longer hospital stay and a poor prognosis. [ncbi.nlm.nih.gov]
[…] diverticular disease infection malignant diseases gastrointestinal tumors direct tumor invasion trauma: blunt or penetrating autoimmune iatrogenic e.g. perioperative Esophageal perforation is technically a bowel perforation, but the causes, evaluation, and prognosis [radiopaedia.org]
The prognosis of DLBCL patients with GI involvement was retrospectively investigated regarding treatments. [bloodjournal.org]
Etiology
Various etiologies have been suggested for colonic perforations; however, the distribution of these etiologies across the globe is variable. [tropicalgastro.com]
The etiology of these 'nonspecific' ulcers is unknown despite the elaboration of many theories. [ijpmonline.org]
It is entirely possible, that due to its rarity, the exact etiology and pathogenesis remains has not been elucidated. [oatext.com]
The broad differential diagnosis for abdominal pain requires a high index of suspicion to make an accurate diagnosis of foreign body ingestion as the etiology. [ncbi.nlm.nih.gov]
Etiology (Exemples) Cystic fibrosis digestive cystic fibrosis colonic cystic fibrosis neontatal necrotizing enterocolitis neonatal digestive mucormycosis (gastrointestinal mucormycosis) ( 17986761 ) Hirschsprung disease immature ganglia imperforate anus [humpath.com]
Epidemiology
This review appraises existing evidence on the epidemiology and mechanisms of perforation, highlights areas of further study, and suggests an epidemiological approach towards preventing the condition. [pmj.bmj.com]
Reference article This is a summary article ; read more in our article on bowel perforation. epidemiology depends on the cause presentation history may depend on the location of the perforation severe and generalised abdominal pain (upper) gradual and [radiopaedia.org]
[Crossref] 15) Ngyuen GC, Sam J, Anand N (2011) Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States. World J Gastroenterol 17: 1600-1605. [oatext.com]
An epidemiologic and clinical study with special reference to incidence and survival. Acta Chir Scand. 1987;153:607–14. Runkel NS, Schlag P, Schwarz V and Herfarth C. Outcome after emergency surgery for cancer of the large intestine. [tropicalgastro.com]
In the case that we present, MA fit the epidemiologic profile of severe BD very well. He is male, first developed symptoms of BD at age 18, and originates from the Middle East. [austinpublishinggroup.com]
Pathophysiology
Chapters discuss triage, life and death situations, major presenting symptoms, diagnostic imaging, and pathophysiology of emergency illness. [books.google.ro]
[…] location of the perforation severe and generalised abdominal pain (upper) gradual and localised pain (lower) anorexia, nausea and vomiting examination rigid abdomen and generalised tenderness guarding and rebound bowel sounds range from quiet to absent pathophysiology [radiopaedia.org]
The purpose of this study was to examine the pathophysiology of colonic perforations in diagnostic colonoscopies caused by looping of the colonoscope in the sigmoid colon. We discuss the findings in relation to those of the current literature. [labome.org]
The pathophysiology of medication induced colon toxicity can progress to a perforated colon and potentially death. [elsevier.es]
The possible reasons for the high mortality and morbidity rates at that time may have been related to the following factors: Knowledge in the area of bowel injuries and the pathophysiologic changes triggered by such injuries was inadequate Clinical skills [emedicine.medscape.com]
Prevention
You will also be given antibiotics to prevent infection in the abdominal cavity. [health.cvs.com]
In conclusion, bowel perforation following stent placement can be a major complication, so close follow-up is necessary to detect it as soon as possible and prevent it from becoming an irreparable complication. [ncbi.nlm.nih.gov]
Prevention This problem may be caused by accidents. These are hard to prevent. It may also be caused by some intestinal disorders. Managing these problems may lower the risk. [winchesterhospital.org]
On the other hand, stercoral perforation of colon and rectum can be prevented. [omjournal.org]