Diastatic perforation of cecum as a result of obstructed colon

Abstract

Introduction. Acute intestinal obstructions in the colon are mostly caused by colon cancer. Evolution can be complicated by ruptures and diastatic perforation of the cecum. Aim of study. The aim of the study is to present the surgical solutions of rare cases of diastatic cecum perforations. Methods and materials. There are 5 presented cases in which, on the installed occlusive background, diastatic ruptures with perforation of the cecum colon had occurred, 3 men and 2 women with an average age of 52.7 years. Plain abdominal radiography shows pneumoperitoneum associated with hydro-aeric levels in 3 cases and in 2 cases hydro-aeric levels on the check colon greater than 10 centimeters Results. Indications for surgery were diffuse peritonitis (3 cases) and acute intestinal occlusion (2 cases). Occlusive tumor was located on the sigmoid colon in 2 cases, on the recto-sigmoid segment in other 2 cases and in one case on the descending colon. Surgeries performed: a) Right hemicolonectomy associated with Hartmann's rectosigmoid resection with ileostoma and transversostoma b) Right hemicolonectomy with Hartmann's descendeto-sigmoid resection with ileotransversostomy. Postoperative evolution without deaths Conclusion. 1. Diastatic cecum perforation is a serious evolutive complication of colonic tumor processes under the condition of ileo-cecal valve being functional 2. The operative act must solve the occlusive cause and the diastatic perforation of the cecum colon, performed by optimal resections of the colon with the preservation of an intermediate colon segment and must have a visa for oncological resolution 3. The postoperative quality of patient's life is acceptable, taking in consideration an afterward restore of the intestinal transit.