Abstract
Idiopathic perforation of the transverse colon is a rare type of colonic perforation. Only 16 cases have been reported until date in Japan. Recently, we encountered the case of a 58-year-old woman with peritonitis secondary to perforation of the transverse colon, in whom we had to perform emergency surgery. Intraoperatively, muddy ascites and localized green-colored swelling of the mesentery located 10 cm proximal to the splenic flexure were noted. The patient's postoperative course was uneventful and she was discharged on the 25th hospital day without any complications. We could not identify the specific cause of the perforation either from the clinical or the histopathological findings. Therefore, we diagnosed the patient as a case of idiopathic perforation of the transverse colon. Herein, we report the case with some review of the literature on idiopathic perforation of the transverse colon.
Idiopathic colonic perforation is most commonly encountered in the sigmoid colon ; on the other hand, the reported frequency in the transverse colon is about 8%. Furthermore, it occurs more often on the antimesenteric side than on the mesenteric side. Although our case was an untypical case of idiopathic colon perforation, the clinical course was favorable because of the localized involvement.
