Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma
Most colorectal cancer patients in the early stages of the disease do not display any alarming symptoms. A total percentage of 9-27% of colorectal cancer patients present with acute abdomen, bowel obstruction, perforation, or bleeding. Perforation as the first presentation of the disease is seen in...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2020/9371071 |
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| author | Daniel Paramythiotis Anestis Karakatsanis Moysis Moysidis Diamantoula Pagkou Petros Bangeas Antonios Michalopoulos |
| author_facet | Daniel Paramythiotis Anestis Karakatsanis Moysis Moysidis Diamantoula Pagkou Petros Bangeas Antonios Michalopoulos |
| author_sort | Daniel Paramythiotis |
| collection | DOAJ |
| description | Most colorectal cancer patients in the early stages of the disease do not display any alarming symptoms. A total percentage of 9-27% of colorectal cancer patients present with acute abdomen, bowel obstruction, perforation, or bleeding. Perforation as the first presentation of the disease is seen in no more than 2.6-10% of patients. Intestinal perforation may be found on either the site of the tumor or on a more proximal site, caused by distention of the bowel due to peripheral obstruction. This is a case of a 75-year-old female patient who presents in the emergency department with retroperitoneal cecal perforation due to an obstructing tumor of the ascending colon. She underwent an emergency right hemicolectomy and washout of the retroperitoneal space. The cecum is not an unusual site of distention and subsequent perforation in the case of colonic obstruction, especially in the presence of a competent ileocecal valve. While the mechanism of diastatic cecal perforation is well described, it is the first time in the literature that this does not occur on the anterior surface of the organ. In our case, cecal perforation presents as a retroperitoneal abscess without peritoneal spillage. Nonetheless, it still carries a grim prognosis and urgent surgical intervention is needed. |
| format | Article |
| id | doaj-art-d79489fdacf94ff4a0d13ee71237752a |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-d79489fdacf94ff4a0d13ee71237752a2025-02-03T06:43:40ZengWileyCase Reports in Surgery2090-69002090-69192020-01-01202010.1155/2020/93710719371071Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon AdenocarcinomaDaniel Paramythiotis0Anestis Karakatsanis1Moysis Moysidis2Diamantoula Pagkou3Petros Bangeas4Antonios Michalopoulos51st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Greece1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Greece1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Greece1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Greece1st University Surgery Department, Papageorgiou General Hospital of Thessaloniki, Greece1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, GreeceMost colorectal cancer patients in the early stages of the disease do not display any alarming symptoms. A total percentage of 9-27% of colorectal cancer patients present with acute abdomen, bowel obstruction, perforation, or bleeding. Perforation as the first presentation of the disease is seen in no more than 2.6-10% of patients. Intestinal perforation may be found on either the site of the tumor or on a more proximal site, caused by distention of the bowel due to peripheral obstruction. This is a case of a 75-year-old female patient who presents in the emergency department with retroperitoneal cecal perforation due to an obstructing tumor of the ascending colon. She underwent an emergency right hemicolectomy and washout of the retroperitoneal space. The cecum is not an unusual site of distention and subsequent perforation in the case of colonic obstruction, especially in the presence of a competent ileocecal valve. While the mechanism of diastatic cecal perforation is well described, it is the first time in the literature that this does not occur on the anterior surface of the organ. In our case, cecal perforation presents as a retroperitoneal abscess without peritoneal spillage. Nonetheless, it still carries a grim prognosis and urgent surgical intervention is needed.http://dx.doi.org/10.1155/2020/9371071 |
| spellingShingle | Daniel Paramythiotis Anestis Karakatsanis Moysis Moysidis Diamantoula Pagkou Petros Bangeas Antonios Michalopoulos Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma Case Reports in Surgery |
| title | Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma |
| title_full | Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma |
| title_fullStr | Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma |
| title_full_unstemmed | Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma |
| title_short | Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma |
| title_sort | retroperitoneal cecal perforation resulting from obstructive ascending colon adenocarcinoma |
| url | http://dx.doi.org/10.1155/2020/9371071 |
| work_keys_str_mv | AT danielparamythiotis retroperitonealcecalperforationresultingfromobstructiveascendingcolonadenocarcinoma AT anestiskarakatsanis retroperitonealcecalperforationresultingfromobstructiveascendingcolonadenocarcinoma AT moysismoysidis retroperitonealcecalperforationresultingfromobstructiveascendingcolonadenocarcinoma AT diamantoulapagkou retroperitonealcecalperforationresultingfromobstructiveascendingcolonadenocarcinoma AT petrosbangeas retroperitonealcecalperforationresultingfromobstructiveascendingcolonadenocarcinoma AT antoniosmichalopoulos retroperitonealcecalperforationresultingfromobstructiveascendingcolonadenocarcinoma |