Two Cases of Foreign-Body Perforation of the Colon Preoperatively Diagnosed by CT

Abstract

We report 2 cases of colon perforation caused by ingestion of foreign bodies. Case 1: A 37-year-old man visited our hospital complaining of abdominal pain, abdominal distension and diarrhea. Physical examination revealed tenderness, rebound tenderness, and muscle guarding in lower abdominal region. Abdominal CT showed wall thickening of the small intestine in the pelvic region and a linear high-density area on the right side of the rectum. Colon perforation caused by a foreign body was diagnosed and surgery was performed. Intraoperatively, a toothpick was found to penetrate the right side of the rectosigmoid wall. The rectosigmoid colon was resected and a single-barrel sigmoid colostomy was performed. Case 2: A 75-year-old man complaining of lower abdominal pain was admitted to our hospital with suspected panperitonitis. Physica1 examination showed tenderness and muscle guarding throughout the abdomen. Abdominal CT revealed thickening of the wall of the sigmoid colon, which contained an arc-shaped high-density area. Emergency operation was performed, which revealed a fish bone penetrating the sigmoid colon. We then performed sigmoidectomy and a single-barrel descending colostomy and removed the fish bone.