A Case of Sigmoid Colon Perforation Due to Upper Gastrointestinal Radiography Cured by Conservative Therapy

Abstract

A 74-year-old woman was admitted suffering from lower abdominal pain ３ days after a barium upper gastrointestinal radiography. After admission, localized lower abdominal pain persisted over ３ days. Many times of abdominal plain X-ray and CT were performed and indicated massive feces and residual barium in the sigmoid colon, but no evidence of free air. Because of severe streak artifacts of residual barium in the CT images, we could not diagnose as Sigmoid colon perforation into the mesocolon. So we tried drainage by the transanal decompression tube. After the excellent drainage of massive feces and residual barium by the transanal decompression tube, the patient was rapidly getting better. At this point we diagnosed this case as Sigmoid colon perforation into the mesocolon. Oral liquid and solid intakes were resumed in 6th days and 22nd days after admission. Therapeutic process was satisfactory and the patient was discharged on the 33rd days without any surgery. Sigmoid colon perforation into the mesocolon after upper gastrointestinal radiography is rare, and this case was cured by conservative therapy. Now we introduce this precious experience with a review of the literature.