A CASE OF ILEAL PERFORATION DUE TO WIRE CORD TRACTION

Abstract

The case was an 81-year-old woman. She had sudden abdominal pain on January 31, 2006, and the pain continued for two days, whereupon she was brought by ambulance and admitted to our hospital. We recognized free air in an abdominal X-ray examination. Abdominal CT revealed a distended ascending colon and fluid collection around it. An emergency laparotomy was performed with a diagnosis of panperitonitis due to colonic perforation. The perforation site was the small intestine which was located 50cm on the oral side of the terminal ileum. There was a 25-cm-long wire-cord connected with the perforated serosa. We performed partial resection of the ileum. Operative findings showed a 2-mm perforated hole but no other mucosal abnormality macroscopically. Postoperative course was uneventful and she was discharged on February 14, 2006. This was a very interesting and rare case of ileal perforation caused by the wire cord tracted and bridging across the intestinal mesentery. We present the case with a review of the literature.