Management of patients with stercoral perforation of the sigmoid colon: Report of five cases

Table 1 Perioperative data on patients with stercoral perforation of the colon

Patient Number	Gender	Age	Interval (day)1	Case history	X-ray finding	Peritonitis	Localization	Perforation size (cm) and site	Fecaloma
A	F	4	1	Chronic constipation	Subdiaphragmatic free air	Generalized	Mid-sigmoid Colon	1 × 0.8 Anti-mesocolic	Within abdominal cavity
B	M	70	3	Chronic constipation, Cushing’s syndrome	Subdiaphragmatic free air	Generalized	Rectosigmoid colon junction	5 × 3 Anti-mesocolic	Within the colon
C	F	84	2	Chronic constipation, D.M.	Subdiaphragmatic free air	Generalized	Sigmoid Colon	3 × 2, Anti-mesocolic	Protruding through perforation
D	F	79	1	Chronic constipation, stroke	Subdiaphragmatic free air	Lower abdomen	Mid-sigmoid Colon	2.5 × 1.5, Anti-mesocolic	Within the colon
E	M	64	2	Chronic constipation, D.M., hypothyroidism, gouty arthritis	Extraluminal free air	Generalized	Sigmoid Colon	4 × 2, Anti-mesocolic	Within the colon

¹ between symptom to operation.

Table 2 Perioperative data of patients with stercoral perforation of the colon

Patient number	Pathology	Ascites culture1	Colonoscopy2	Stercoral ulcer at proximal colon	Operation procedures	Peritoneal lavage3	Complication
A	Fecal peritonitis	E. coli, Enterococcus faecalis, B. Fragilis	No	Undetectable	Segmental colectomy+diverting enterostomy	Plenty	Nil
B	Purulent ascites	Enterococcus faecalis, B. fragilis	Yes (65, A-colon)	Four shallow stercoral ulceration diffusely	Hartmann’s operation+rectal mucus fistula	Moderate	Mortality (overwhelming sepsis at post-op 21st d)
C	Fecal peritonitis	E. coli	Yes (50, proximal T-colon)	No ulceration	Hartmann’s operation+rectal mucus fistula	Massive	Superficial wound infection
D	Purulent ascites	E. coli, Kleb. pneumonia, B. thetaiotaomicron	Yes (75, A-colon)	No ulceration	Segmental colectomy+diverting enterostomy	Massive	Superficial wound infection
E	Purulent ascites	E. coli, Enterococcus faecium, Bacteroides sp.	Yes (80, A-colon)	No ulceration	Hartmann’s operation+rectal mucus fistula	Massive	Fascial dehiscence

¹Heavy flora cultured as.

²(cm) distance at the most proximal to perforation and location.

³Massive: > 10 000 mL; moderate: < 6 000 mL; plenty: 1 500 mL.