Department of Surgery, University of Toledo Medical Centre, Toledo, OH, USA.
Am Surg. 2023 Jun;89(6):2885-2887. doi: 10.1177/00031348221075733. Epub 2022 Feb 5.
Stercoral ulcers are localized areas of loss of colonic mucosal integrity. They result from pressure necrosis of the colonic mucosa, secondary to chronic constipation and fecal inspissation. These ulcers are rare and, are associated with serious complications, including bleeding and perforation. We present the case of a 50-year-old woman who presented with small bowel evisceration through the anal canal secondary to extraperitoneal perforation of the rectum. The patient underwent emergent exploratory laparotomy with reduction of the bowel, followed by second look laparotomy in 24 hours. A full thickness defect in the rectum was identified and Hartmann's procedure was performed. The patient's postoperative course was uneventful. Extraperitoneal perforation and evisceration of bowel is a rare clinical entity. These cases are diagnosed early due to the obvious clinical presentation and however may be misdiagnosed as prolapse. They necessitate urgent and careful surgical planning, to ensure preservation of bowel and complete recovery.
粪石性溃疡是结肠黏膜完整性局部丧失的区域。它们是由于慢性便秘和粪便浓缩导致结肠黏膜的压迫性坏死引起的。这些溃疡很少见，但与严重并发症有关，包括出血和穿孔。我们报告了一例 50 岁女性的病例，该患者因直肠浆膜外穿孔导致小肠通过肛管脱出，出现小肠脱出。患者接受了紧急剖腹探查术，进行了肠复位，然后在 24 小时后进行了第二次探查术。发现直肠有全层缺损，并进行了 Hartmann 手术。患者的术后过程顺利。肠浆膜外穿孔和肠脱出是一种罕见的临床实体。由于明显的临床表现，这些病例通常可以早期诊断，但可能被误诊为脱垂。它们需要紧急和仔细的手术计划，以确保保留肠道并完全恢复。
