Abstract
BackgroundSpontaneous colonic perforations are scarce, and cecal perforations even more so. Preoperative diagnosis of the latter in a pregnant woman is particularly difficult because of physiologic changes and restrictions on some diagnostic imaging techniques, such as X-rays. Furthermore, management of these patients is a big challenge.Case presentationWe present a case of a spontaneous cecal perforation in a 40-year-old pregnant black woman in the Regional Hospital of Bafoussam in Cameroon. The results of clinical examination and ultrasonography on admission were in line with acute generalized peritonitis in a woman at 20 weeks of a viable pregnancy, indicating an urgent laparotomy. Operative findings were a 1 × 1-cm perforation on a distended cecum with minimal fecal contamination. The treatment consisted of excision of the edges, primary suture of the perforation, and omentoplasty. The recovery of the patient was uneventful.ConclusionsThe management of spontaneous cecal perforation in a pregnant woman was a big challenge. The perforation was repaired by primary suture and omentoplasty. Further studies comparing this approach with right hemicolectomy are recommended.
Highlights
BackgroundSpontaneous perforation of the colon is defined as a sudden perforation of an apparently healthy colon in the absence of any other disease or injury
Spontaneous colonic perforations are scarce, and cecal perforations even more so
The perforation was repaired by primary suture and omentoplasty
Summary
Spontaneous perforation of the colon is defined as a sudden perforation of an apparently healthy colon in the absence of any other disease or injury. Case presentation Our patient was a 40-year-old multiparous pregnant black woman at a gestational age of 20 weeks who was not compliant with antenatal care. She had no history of weight loss, chronic constipation, or blood per rectum, nor did she or her relatives report a previous laparotomy. She was brought to our institution’s emergency department by her family 6 days after the onset of a progressively painful abdominal distention, bilious vomiting with fever, and asthenia. The patient was discharged on day 10 and referred to an obstetrician for the continuation of antenatal care
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