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Case Report
Toxic megacolon and perforation of the right colon due to sigmoid stenosis associated to chronic diverticulitis
1 PhD, General Surgeon, Esophagogastric Department Gregorio Marañon University General Hospital, Madrid, Spain
2 PhD, General Surgeon, Gregorio Marañon University General Hospital, Madrid, Spain
3 PhD, General Surgeon, Hepatobiliary Department, Gregorio Marañon University General Hospital, Madrid, Spain
Address correspondence to:
Maria Tudela Lerma
Duque de Sesto 17, 5º C, 28009, Madrid,
Spain
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Article ID: 100056Z12ML2018
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Lerma MT, Hidalgo AM, Zorita BD. Toxic megacolon and perforation of the right colon due to sigmoid stenosis associated to chronic diverticulitis. J Case Rep Images Surg 2018;4:100056Z12ML2018.ABSTRACT
Introduction: Diverticulosis is a common benign disease in the population over the age of 60. It ranges from asymptomatic to complicate with bleeding or perforation. “Chronic diverticulitis” is defined by its chronic clinical course and luminal obstructive change (stenosis), which may rarely lead in large bowel obstruction. Colonic dilation can cause toxic megacolon and perforation.
Case Report: This is a rare case of toxic megacolon accompanied by perforation of the right colon due to chronic dilatation caused by stenosis of the sigmoid colon as a complication of diverticulitis. The patient consulted in emergency for abdominal pain and developed severe septic shock. The computed tomography showed dilatation of the colon with perforation and large retroperitoneal abscess. An emergency total colectomy was performed.
Conclusion: To the best of our knowledge there are very few reports in the literature referring to toxic megacolon and perforation of the right colon due to stenosis of the sigmoid colon as a result of chronic diverticulitis.
Keywords: Colonic dilatation, Colon perforation, Colon stenosis, Diverticulitis complication, Toxic megacolon
SUPPORTING INFORMATION
Author Contributions
Maria Tudela Lerma - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ana Moreno Hidalgo - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Benjamin Diaz Zorita - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2018 Maria Tudela Lerma et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
