Abstract
Patients who had undergone surgery for colorectal perforation were reviewed to evaluate the factors that affect prognosis. There were 24 patients (14 men, 10 women ; mean age 65.2 years, range 26-85 years) treated between January 1991 and December 2003. The causes of colorectal perforation were diverticulitis (n=7), malignancy (n=6), iatrogenic damage (n=5), idiopathic condition (n=3), inflammation (n=2) and injury (n=1). The sigmoid colon and rectum were the most common site of perforation. Five patients who died after surgery were compared with 19 patients who were discharged from the hospital. Significantly different factors were the longer duration from the onset of perforation to surgery, the presence of preoperative shock and other associated diseases. There were five patients with perforated colorectal cancer. Curative resection was the primary treatment in four and all remain alive without recurrence. The other one with metastatic liver tumor underwent sigmoidectomy 18 days after colostomy and remains alive under chemotherapy. In conclusion, the earlier treatment and management of associated diseases are mandatory in patients with colorectal perforation. Primary curative resection for perforated colorectal cancer is the treatment of choice in the absence of the above risk factors.
