CLINICAL STUDY ON IDIOPATHIC PERFORATION OF THE COLON AND RECTUM

Fourteen cases of idiopathic perforation of the colon and rectum experienced at the hospital from April 1984 to September 1991 were clinically studied. Idiopathic colorectal perforation was commonly found in aged women whose bowel tended to shop. These perforations were predominantly located in the antimesenteric side of the rectosigmoid junction and sigmoid colon. Five cases presented shock symptoms, and 4 of them were associated with no increased leukocytes. It took 24 hours or less for 7 cases to be operated on from the onset of the symptoms. All 5 shock cases were included in these 7 cases. Severe cases fell in shock state in an early period, and a significantly large number of them had normal or decreased leukocyte count, compared to others. One out of 14 cases was lost because of postoperative complication. The mortality rate was 7.1%. In a relation between operative procedure and postoperative complications, a significantly lower occurrence of postoperative complication was noted in cases undergoing colostomy. Colostomy appeared valuable to prevent postoperative complications. Infection of the surgical wound was the most common complication, and a significantly longer hospital stay was observed in cases complicated by such wound infection.