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Rectal Perforation


Presentation

  • The object of this report is to present our experience of prenatal extraperitoneal rectal perforation, defining the clinical presentation, management, and progress.[ncbi.nlm.nih.gov]
  • Furthermore, to our knowledge, this is also the first reported case presenting as rectal perforation. PATIENTS AND METHODS: We report a case of prickly pear fruit bezoar occurring in the elderly whom presented with rectal perforation.[ncbi.nlm.nih.gov]
  • The patient's history and physical examination was complicated by multiple factors: she was intoxicated at the time of presentation as well as during the assault; her presentation fluctuated over time, she was obese, and she carried a psychiatric diagnosis[ncbi.nlm.nih.gov]
  • We report the first case of FERP known to be associated with duodenal atresia, which only became clinically apparent after duodenal atresia repair and initially presented a diagnostic difficulty.[ncbi.nlm.nih.gov]
  • METHOD: This is a case presentation and review of literature. We present a case of isolated extraperitoneal rectal perforation secondary to hydrostatic pressure sustained.[ncbi.nlm.nih.gov]
Pseudotumor
  • A biopsy specimen of this pseudotumoral specimen showed many Schistosoma haematobium eggs with an inflammatory reaction surrounding the eggs.[ncbi.nlm.nih.gov]
Wound Infection
  • No fistulae or wound infections occurred, but closure of 1 colostomy was complicated.[ncbi.nlm.nih.gov]
Rigor
  • Our patient was successfully treated with a multidisciplinary approach that involved a defunctioning colostomy as well as prompt and rigorous debridement of the affected limb.[ncbi.nlm.nih.gov]
Perineal Swelling
  • In most of the cases, perineal swelling was apparent within few hours of birth 3 . In a case of Pitcher et al. 1 , the patient even had aplasia cutis, suggesting skin perforation in the buttock region antenatally.[journals.lww.com]
Acute Abdomen
  • In this report, we present a case of child physical abuse resulting in bladder and rectal perforations, which was initially referred to our hospital as acute abdomen with intraperitoneal free fluid on ultrasonography.[ncbi.nlm.nih.gov]
  • J Pioneer Med Sci. 2014; 4(1):49-51 Case Report ABSTRACT Spontaneous perforation of the colon or rectum is a rare cause of acute abdomen in surgery.[jpmsonline.com]
  • abdomen in surgical practice.[nepjol.info]
  • "Gastrointestinal perforation and the acute abdomen". The Medical Clinics of North America. 92 (3): 599–625, viii–ix. doi : 10.1016/j.mcna.2007.12.004. PMID 18387378.[en.wikipedia.org]
Tachycardia
Palpable Purpura
  • In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children.[ncbi.nlm.nih.gov]
Arthralgia
  • In addition to palpable purpura, arthritis or arthralgia, renal disease and abdominal pain, gastrointestinal symptoms occur in 50% of children.[ncbi.nlm.nih.gov]

Treatment

  • The clinical presentation, course of disease and response to treatment supported the concept of CMV as a primary aetiological agent.[ncbi.nlm.nih.gov]
  • Recognition and treatment with fecal diversion and long-term intravenous antibiotics is an alternative to device removal and sacral reconstruction. Copyright 2013 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • Abstract Haemorrhoidal artery ligation has now been established as a treatment modality for symptomatic haemorrhoids.[ncbi.nlm.nih.gov]
  • Bowel perforation under antiangiogenic TKI treatment is in most cases of early occurrence, in the first months (up to five months) if not the first weeks of treatment.[em-consulte.com]
  • Since that time, much has been learned about the treatment of patients with peritonitis and bowel perforation, many new and more effective antibiotics have become available, and the management of shock has become infinitely more sophisticated.[ncbi.nlm.nih.gov]

Prognosis

  • Hence the better prognosis is with early surgical intervention; worst the prognosis with late intervention. Birat Journal of Health Sciences 2016 1(1): 87-90 Downloads Download data is not yet available. How to Cite Singh, R. (2017).[nepjol.info]
  • If treated timely, this disease is associated with good prognosis and normal function.[journals.lww.com]
  • Severe GI involvements such as bleeding and perforations have been reported to be major factors of poor prognosis [ 6 ].[surgicalcasereports.springeropen.com]
  • We believe that establishing a standard treatment for CRT-related LARC perforation may improve the prognosis of such cases.[wjgnet.com]
  • Prognosis A GI perforation is a medical emergency and requires quick recognition of the signs and symptoms, and rapid medical response. When this occurs, recovery should be complete.[sepsis.org]

Etiology

  • As none of the reported causes of intestinal perforation were identified in our case, its etiology remained idiopathic.[ncbi.nlm.nih.gov]
  • Spontaneous perforation of the rectum with possible stercoral etiology: report of a case and review of the literature. Surg Today 1998; 28:937–939. Schein M, Decker GAG. Spontaneous perforation of the rectum. SAMJ 1986; 69:388-389.[jpmsonline.com]
  • Its etiology and pathophysiology are poorly understood. Only 16 cases have been reported worldwide. We report another case of fetal extraperitoneal rectal perforation managed by us.[journals.lww.com]
  • Nontraumatic Large Bowel Perforation: Spectrum of Etiologies and CT Findings. Abdominal Radiology. 2017 May 10. (Epub ahead of print). Yamauchi, A., Kudo, S., Mori, Y. et al.[verywell.com]

Epidemiology

  • Haggar FA, Boushey RP: Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg. 2009; 22 (4): 191–7. PubMed Abstract Publisher Full Text Free Full Text 2.[f1000research.com]
Sex distribution
Age distribution

Pathophysiology

  • Its aetiology and pathophysiology are poorly understood. Rapid recognition by its classical signs is mandatory as delay in diagnosis leads to serious morbidity. We report a fourth case, and make recommendations regarding management.[ncbi.nlm.nih.gov]
  • Its etiology and pathophysiology are poorly understood. Only 16 cases have been reported worldwide. We report another case of fetal extraperitoneal rectal perforation managed by us.[journals.lww.com]

Prevention

  • Simple measures like wearing protective garments might be enough to prevent them. Complete defunctioning colostomy is better in these cases than partially defunctioning colostomy.[ncbi.nlm.nih.gov]
  • Surgical repair of rectal perforation and intensive treatment did not prevent development of acute respiratory distress syndrome (ARDS) and systemic inflammatory response syndrome (SIRS) hence leading to multiple organ dysfunction syndrome (MODS) and[ncbi.nlm.nih.gov]
  • Pescatori, M, Quondamcarlo, C 1999 Prevention of intraoperative complications during stapled excision of rectal mucosal prolapse Tech Coloproct 3 103 104 Google Scholar 5.[link.springer.com]
  • This case report of rectal perforation in a neonate secondary to anal stenosis discusses the associated diagnostic and management complexities in order to prevent future complications.[jpss.eu]
  • A well-conducted preoperative evaluation of the lesions tends to prevent such complications.[urologyannals.com]

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