特発性大腸穿孔再発の１例

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  • A CASE OF RECURRED IDIOPATHIC PERFORATION OF THE COLON-A CLINICAL STUDY OF OUR CASES OF IDIOPATHIC PERFORATION OF THE COLON-

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The patient was an 85-year-old woman who had undergone exteriorization for an idiopathic perforation of the descending colon 5 years earlier. She again had an idiopathic perforation of the transeverse colon and underwent a Hartmann's procedure 6 hours after the onset of the symptom. At laparotomy, a perforation 35mm in diameter was observed near side of the splenic flexure. The pathological diagnosis was idiopathic perforation. Postoperatively she recovered from MOF and DIC, but died of aspiration pneumonia on the 141st day after the operation.<br> There were 9 patients who underwent surgical treatment at our hospital because of idiopathic perforation of the colon for recent 6 years. The male-to-female ratio was 2:7 (mean age: 80 years). Perforated site was the sigmoid colon in all 8 cases except one recurred case. Colostomy was made in all cases (Hartmann's procedure in 6 cases and exteriolization in 3 cases). Mean interval from the onset to operation was 11 hours. Mean diameter of perforations was 30mm. Despite of intensive cares including artificial respiration, hemodialysis, and PMX, the death rate was high, 33%, because most patients were aged and had some underlying diseases.

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