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 19 June 2018

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GastroenterologyColo-rectum and anus

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Stercoral perforation of the colon.
A 76-year old woman admitted with a six-day history of increasing abdominal pain. Two weeks earlier she had undergone a total knee replacement and at the time of her readmission was convalescing from this procedure. Her bowels had not worked for 8 days. On examination she had a temperature of 38C and a generalised peritonitis. At operation she had stercoral ulceration of the sigmoid colon with faecal contamination of the peritoneal cavity. The photograph shows the ulcerated section of sigmoid colon with faecal material visible. She was grossly constipated. A Hartmann's procedure (sigmoid colectomy with end-colostomy) was performed.

Comment: stercoral ulceration is a rare cause of colonic perforation, responsible for less that 3% of all perforations. Not treated promptly, this condition is associated with a high mortality.


Peter Devitt, Adelaide, Australia

Stercoral perforation of the colon.

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