[Clinical analysis of stercoral perforation of the colon]

Abstract

Background/aims: A stercoral perforation of the colon (SPC) is a rare, life-threatening disease. The aim of this study was to represent the definition of SPC and help the diagnosis and treatment of this condition.

Methods: We reviewed 92 medical records of patients who underwent operation due to colonic perforation from January 2000 to February 2009 retrospectively. Maurers diagnostic criteria were used for the diagnosis of SPC.

Results: Eight patients (8.7%) were diagnosed as SPC. The age of the patients ranged from 59 to 85 years old. All of the patients were female and had a history of long-standing constipation. Only two patients (25%) were diagnosed as SPC preoperatively. The site of perforation of all patients was sigmoid colon. The methods of operation were Hartmanns procedure (7 cases), and primary repair with sigmoid loop colostomy (1 case). There were one recurrence and two deaths (25%) due to sepsis and multiple organ failure.

Conclusions: SPC should be considered in chronically constipated, and bedridden patients who present with acute abdomen. Hartmanns procedure is the treatment of choice in most situations. Mortality is high but can be minimized with early definitive surgery.