Abstract
We report a case of a 69-year-old female previously diagnosed with advanced low rectal cancer, who had undergone preoperative chemoradiotherapy followed by laparoscopic ultralow anterior resection, upper D2 lymph node dissection, and ileostomy with double orifices. Approximately 4 months after commencing chemoradiotherapy and 2 months after proctectomy, the patient consulted our hospital with the primary complaints of abdominal pain and fever and bloody diarrhea. Computed tomography on admission revealed an intestinal perforation and emergency surgery was performed. Intraoperative findings revealed an ileal perforation approximately 15cm from the ileostomy. The patient was diagnosed with idiopathic intestinal perforation on the basis of the history of treatment for rectal cancer, preoperative imaging diagnosis, and intraoperative findings. Surgery included closure of the perforation and lavage drainage. Because histopathological examination was not possible, no definitive diagnosis was reached; however, the intestinal perforation may have been due to the delayed effects of chemoradiotherapy. In conclusion, we report an extremely rare case of idiopathic intestinal perforation possibly caused by the delayed effects of chemoradiotherapy along with a short literature review.
