Abstract
A case experiencing two idiopathic perforations of the colon is reported. A 78-year-old woman who had undergone Hartmann's procedure for idiopathic perforation of the rectum on 26 March 2006, presented with sudden left lower abdominal pain on 1 February 2009. She was admitted to the hospital for conservative treatment but her symptoms worsened. Colonoscopy showed partial necrosis of the sigmoid colon mucosa and a round recess in proximity (5cm) to a colostomy. Computerized tomography revealed the formation of an abscess cavity and penetration to the mesentery. An operation was thus performed. At laparotomy, a perforation 3cm in diameter was observed on the oral side 5cm from the colostomy. The pathological diagnosis was idiopathic perforation. Only four cases with repeated idiopathic perforation of the colon have been reported in the Japanese literature. Idiopathic colon perforation is associated with many unexplained factors, and can occur repeatedly. Careful observation, including a complete history of bowel habits, is required in the outpatient clinic.
