Serpell J W, Nicholls R J
Department of Surgery, St. Thomas' Hospital, London, UK.
Br J Surg. 1990 Dec;77(12):1325-9. doi: 10.1002/bjs.1800771204.
Stercoral perforation of the colon is rare. The 64 reported cases are reviewed to define the syndrome of stercoral perforation, and to facilitate accurate diagnosis and treatment. Features of localized or generalized peritonitis were universal; however, only 11 per cent were correctly diagnosed before operation. Recognition that the disease involves a segment of colon rather than only the focal point of perforation is essential to adequate surgical treatment. It is postulated that this is the reason for the higher postoperative mortality following closure of the perforation and proximal colostomy (57 per cent) or exteriorization alone (43 per cent), compared with resection of the diseased segment and exteriorization (32 per cent). Resection and exteriorization is therefore the treatment of choice is most situations.
结肠粪性穿孔较为罕见。本文回顾了64例已报道病例，以明确结肠粪性穿孔综合征，并促进准确的诊断和治疗。局限性或全身性腹膜炎的特征普遍存在；然而，术前仅有11%的病例得到正确诊断。认识到该病累及结肠的一段而非仅穿孔的焦点，对于充分的手术治疗至关重要。据推测，这就是为什么与切除病变肠段并外置（32%）相比，单纯缝合穿孔和近端结肠造口术（57%）或仅外置术（43%）术后死亡率更高的原因。因此，在大多数情况下，切除并外置术是首选的治疗方法。
