Abstract
We report a rare case of perforation of the sigmoid colon diagnosed seven days after colonoscopy. A 61-year-old female initially underwent a flexible colonoscopy at the department of internal medicine in December 2008. Seven days after the examination, she developed nausea and abdominal pain. There was rebound tenderness and distention of the entire abdomen. An abdominal computed tomography demonstrated free air and ascites. Then an emergency operation was performed with a suspicion of panperitonitis due to perforation of the colon. We performed sigmoidectomy and colostomy (Hartmann's procedure) due to the finding of a perforation in the sigmoid colon and a necrotic change of mesocolon. At postoperative course, patient was treated with polymyxin B by direct hemoperfusion and with neutrophil elastase inhibitor. She overcame her severe condition and was free from the respirator on the eighth postoperative day. She was discharged from our hospital at day 52 after the initial operation. In March 2009 we closed the colostomy. Now she is doing well and healthy.
