Tokunaga Y, Hata K, Nishitai R, Kaganoi J, Nanbu H, Ohsumi K
Department of Surgery, Maizuru Municipal Hospital, Kyoto, Japan.
Surg Today. 1998;28(9):937-9. doi: 10.1007/s005950050256.
Stercoral perforation of the colon or rectum is a rare cause of acute abdomen, with fewer than 70 cases documented in the literature. We report herein the case of a 60-year-old man who presented with anuria and epigastric pain with physical signs of peritonitis. An abdominal X-ray showed bilateral subphrenic free air accumulation, and an emergency laparotomy subsequently revealed perforation of the rectum, suggestive of a stercoral cause, which was treated by simple closure after debridement. Following an uneventful postoperative course, he was discharged from the hospital 3 weeks after his operation and is now doing well without having suffered any further gastrointestinal problems. The clinical features, diagnosis, and treatment of the disease are reviewed following the presentation of this case. Surgeons should be aware of the possibility of this fatal disease, despite its rare incidence. Furthermore, it is important to recognize the condition at an early stage because it has a significantly high mortality if not treated early. Conversely, the surgical outcome is satisfactory provided surgery is performed in due time.
结肠或直肠粪性穿孔是急腹症的一种罕见病因，文献记载的病例不足70例。我们在此报告一例60岁男性患者，其表现为无尿和上腹部疼痛，并伴有腹膜炎体征。腹部X线显示双侧膈下有游离气体积聚，随后的急诊剖腹探查发现直肠穿孔，提示为粪性病因，经清创后行单纯缝合治疗。术后恢复顺利，患者术后3周出院，目前情况良好，未出现任何进一步的胃肠道问题。在介绍该病例后，对该疾病的临床特征、诊断和治疗进行了综述。尽管该病发病率很低，但外科医生应意识到这种致命疾病的可能性。此外，早期识别该疾病很重要，因为如果不早期治疗，其死亡率会显著升高。相反，如果及时进行手术，手术效果是令人满意的。
