Radionov M, Kovachev S, Ziia D D
Khirurgiia (Sofiia). 2004;60(4-5):60-2.
The authors report five cases of spontaneous perforation of the large bowel for a five year period. The clinical symptoms were dominated by the feculent peritonitis. There were found no data of previous diseases of the colon during the operations and hystologically. By all five patients was manifested severe constipation before the incident. During the operation the recto sigmoid and the left colon were found plugged by stercolithes with "stone density". A hypothesis of stercoral pathogenesis of the perforations is suggested. Conclusions for the surgical tactics in the conditions of large bowel peritonitis due to benign perforation are done.
作者报告了五年期间五例大肠自发性穿孔的病例。临床症状以粪性腹膜炎为主。手术过程中和组织学检查均未发现结肠既往疾病的数据。所有五例患者在发病前均表现为严重便秘。手术中发现直肠乙状结肠和左结肠被具有“结石密度”的粪石堵塞。提出了穿孔的粪石发病机制假说。得出了因良性穿孔导致大肠腹膜炎情况下手术策略的结论。