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Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction

BioMed Central
  • Case Report

Abstract ral World Journal of Surgical Oncology ss BioMed Cent Open AcceCase report Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction Satyendra K Tiwary, Manish K Singh, Rahul Khanna and Ajay K Khanna* Address: Department of General surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India Email: Satyendra K Tiwary - [email protected]; Manish K Singh - [email protected]; Rahul Khanna - [email protected]; Ajay K Khanna* - [email protected] * Corresponding author Abstract Background: Carcinoma of the colon may present with perforation proximal to the site of malignancy. Caecum is the commonest site of perforation if the ileocecal valve is patent and the jejunal and ileal perforations are very rare. Case presentation: A 35 year male presented with intestinal obstruction. Emergency laparotomy revealed carcinoma of the transverse colon with multiple pinpoint perforations along antimesenteric border of ileum, which were wrapped with omentum, and no peritoneal contamination was present. Extended right hemicolectomy with jejunocolic anastomosis was done. Patient made uneventful recovery in postoperative period and was treated with adjuvant chemotherapy. Conclusion: Patients with colonic carcinoma and incompetent ileocecal valve may present with intestinal perforation. Increased intraluminal pressure and closed loop obstruction may lead to ischemia and perforation of the small bowel. Background It is very unusual to find a case of carcinoma colon with associated multiple perforations of proximal part. In 4 to 5% cases, presentation of carcinoma colon is with perfo- ration. In these cases high mortality has been reported in literature from 30 to 40% [1]. Perforation may occur if tumor invades serosal layer, but this perforation is usually solitary and large. Peritoneal contamination is invariably associated. We hereby report a case of carcinoma of trans- verse colon presenting with a

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