Obstructive Colon Cancer with Idiopathic Pneumoperitoneum—Report of a Case—

Abstract

A 73-years-old woman was referred to our department with abdominal pain and presence of free air in a plain x-ray of the abdomen. Laboratory examination showed no elevation of the peripheral blood WBC count or serum CRP. Abdominal CT showed mild amount of free air around of the liver and a mass in the transverse colon. Emergency operation was carried out because of suspected colorectal perforation. Intraoperatively, we recognized a hard mass in the middle region of the transverse colon and obstructive ileus caused by the mass, with no evidence of any colorectal perforation. A traditional expanded right hemi colectomy was performed and the patient was discharged on the 27th hospital day. Based on the operative and pathological findings, we diagnosed the free air in the abdomen as idiopathic pneumoperitoneum caused by the obstructive transvers colon cancer. We report this very rare case with some review of the literature.