Stercoral perforation of the cecum: A case report

Figure 1 Plain radiograph of the patient’s kidneys, ureters, and bladder. The kidneys, ureters, and bladder radiograph displaying a focal lesion in the right lower quadrant of the patient’s abdomen.

Figure 2 Abdominal computed tomography imaging of the patient’s abdomen. A: A suspected bezoar (approximately 7.6 cm) was seen in the dilated cecum (arrow); B: Pericolic fat stranding, mild proximal dilatation of the ileum, pneumoperitoneum and minimal ascites accompanied this lesion.

Figure 3 Intraoperative photographs of gross findings. A: A rounded perforation (7 cm × 5 cm in diameter) of the cecum was intraoperatively noted; B: The cecum was notably thin without any obvious tumorous lesions on the mucosa (as marked); C: Seropurulent fluid was freely present in the peritoneal cavity; D: Fecal contamination was observed in the peritoneal cavity; E: The bezoar extracted from the dilated cecum.

Figure 4 Gross and histopathological examination of the cecal specimen. A: A grossly rounded cecal perforation with ischemic necrosis was observed; B: Microscopically, the muscle layers show lymphoplasma cell infiltration with crypt effacement and hemorrhage.