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
- Rapidly Progressive Glomerulonephritis
We reported the case of a patient affected with upper airways-limited GPA who developed acute renal failure from rapidly progressive glomerulonephritis and then experienced colonic perforation due to CMV colitis a few weeks after immunosuppressive treatment [ncbi.nlm.nih.gov]
- Inguinal Mass
He was initially treated for presumed Clostridium difficile colitis, but later developed a left inguinal mass with spreading erythema. A CT scan showed gas within the retroperitoneal tissues, with surgical emphysema of the left groin. [ncbi.nlm.nih.gov]
- Cerebral Palsy
Patient No. 3 SNA; A 15 year old Female with cerebral palsy & mental retardation. She was bed ridden with chronic constipation and was admitted with a three day history of vomiting, abdominal pain, and distention. [omjournal.org]
Gastrointestinal
- 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]
- 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]
- Chronic Watery Diarrhea
Collagenous colitis is a clinicopathologic syndrome characterized by chronic watery diarrhea and unique histopathologic features. [ncbi.nlm.nih.gov]
- Pelvic Mass
It commonly affects pelvic structures including the bowel. Perforation of the colon by endometriosis is very rare and the patients generally present with an asymptomatic or painful pelvic mass, often in the left iliac fossa. [ncbi.nlm.nih.gov]
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]
Skin
- Night Sweats
She reported no nausea, vomiting, fever, chills, or night sweats, but noted a recent loss of appetite. [hcplive.com]
Neurologic
- Chorea
is a multi-systemic disease being characterized by the presence of antiphospholipid antibodies that involves both arterial and venous systems resulting in arterial or venous thrombosis, fetal loss, thrombocytopenia, leg ulcers, livedo reticularis, chorea [ncbi.nlm.nih.gov]
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]
Pneumoperitoneum due to insufflation of gas at laparoscopy has identical appearances. [radiologymasterclass.co.uk]
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]
Other ECG Findings
- Ischemic Changes
Stercoral perforations are defined as: Linear tears of the colon without ischemic changes. Perforated ulcers caused by an enlarging colonic carcinoma. Perforated colonic ulcers with necrotic and inflammatory edges. [hcplive.com]
Treatment
One of the patients who received Verres needle desufflation underwent secondary surgery because of failure of nonsurgical treatment. [ncbi.nlm.nih.gov]
Therefore, fully covered SEMS can be a good option for the treatment of colonic perforation. However, the efficacy and associated complications of fully covered SEMSs for the treatment of iatrogenic perforation have not been fully clarified. [kjim.org]
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
The etiology of these 'nonspecific' ulcers is unknown despite the elaboration of many theories. [ijpmonline.org]
[…] colonic perforation. 2 Regardless of the etiology, the critical actions for any colonic perforation are quick recognition, medical stabilization, and surgical evaluation. [mdedge.com]
Discussion The etiology of the colon perforation in newborn infant has been still discussed. [ispub.com]
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
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]
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]
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]
The relationship between abdominal pain regions and specific diseases: An epidemiologic approach to clinical practice. J Epidemiol 1997 Mar;7(1):27–32. [ Pubmed ] Locker GY, Hamilton S, Harris J, et al. [edoriumjournals.com]
Epidemiology There is not enough data in the literature on the incidence and prevalence of rectum or colon perforations. [intechopen.com]
Pathophysiology
[…] 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 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]
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]
Prevention
Antibiotic medications may be recommended to treat an infection or prevent an infection from developing. Prevention Some perforations are caused by accidents which are difficult to prevent. [winchesterhospital.org]
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]
You will also be given antibiotics to prevent infection in the abdominal cavity. [health.cvs.com]
On the other hand, stercoral perforation of colon and rectum can be prevented. [omjournal.org]