A CASE OF RECTAL CANCER WITH SUBCTANEUS EMPHYSEMA CAUSING PERFORATION OF THE SIGMOID COLON

Abstract

A 60-year-old woman visited another hospital because of no bowel movement and a stomach-ache lasting for 5 days, and was conveyed to the hospital with a diagnosis of peritonitis. Blood pressure was 86/34mmHg, and pulse was 112/min. There were muscular defense in the abdomen, and subcutaneus enphysema in the face, neck, and chest wall. Plain chest and abdominal X-ray examinations, and CT scan showed subcutaneus enphysema and a large quantity of free air. Emergency operation was carried out with a diagnosis of panperitonitis due to perforation of the colon. Ascites accompanied with stench and stool were found out in the abdominal cavity. There was a rectal cancer, and the sigmoid colon was perforated in the mesenterium side. The rectal cancer and sigmoid colon was resected, and the peritoneal cavity was washed with 35 liter of warm saline. Colostomy was attempted on the oral side colon. The patient became septic shock at the operation, but recovered from septic shock after the operation. Chemotherapy was started on the 39th hospital day, and the patient was discharged from the hospital on the 84th hospital day.