Abstract
The patient was a 77-year-old man who had suffered sudden lower abdominal pain during a bowel movement. Abdominal computed tomography showed marked dilatation of the sigmoid colon which contained massive amounts of stool, and ascites. The patient underwent emergency laparotomy for generalized peritonitis, suspecting perforation of the sigmoid colon. During the operation, a laceration 4cm in diameter was found at the sigmoid colon, and 400 ml of intra-abdominal bleeding was also noted. Neither perforated lesion nor tumorous changes were recognized. On microscopic examination, both ischemic change and a split muscle layer from the colon serosa were observed. The chronic ischemic colitis due to feces might have been the consequence of the laceration of the sigmoid colon which occurred during the bowel movement.
