Stercoral perforation

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Sudden onset severe abdominal pain. O/E Tender +++ with guarding and percussion tenderness ?peritonitis

Patient Data

Age: 60 years
Gender: Female
ct

Fecolith in the mid sigmoid colon.  Small defect on the anterior wall of the mid sigmoid with multiple blebs of adjacent pericolic free gas.  Several small blebs of free gas track into the mesentery. No diverticula. 

Small volume of free fluid in the pelvis and upper abdomen.

Fatty liver.

Case Discussion

Not all sigmoid perforations are from a tumor or diverticular disease. 

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