Abstract
A 29-year-old man complaining of sudden abdominal pain was admitted to our hospital. There was muscle guarding and tenderness of the abdomen. Abdominal plain radiography and abdominal CT scan showed intraperitoneal free air and ascites, so we performed an emergency operation under a diagnosis of panperitonitis due to perforation of the intestine. At laparotomy, the perforation was confirmed at the small intestine 8mm in size, located 270cm distally from Treitz's ligament. We observed along the small intestine around 200cm including the perforated lesion to have thickness of the intestinal wall and dark red discoloration of the intestinal serosa. A partial small intestinal resection including the perforated lesion and the segment showing thickness and dark red discoloration was performed. Gross findings of the resected specimen revealed intact mucosal layer near the perforated lesion. Histologically, ischemic lesion, chronic inflammatory lesion or malignant lesion were not seen and mucosal layer did not slide into serosal side. Finally, he was diagnosed as having idiopathic perforation of the small intestine.
