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Perforation of a sigmoid colon
Perforation of the sigmoid colon in a term neonate is a rare complication. It occurs during the first three weeks of life and has been described in only a few other cases. Most cases occur in the proximal intestine. In this case, sigmoid perforation occurred at the posterior segment of the sigmoid colon. The patient was treated with antibiotics and had a colostomy. She was discharged 14 days later in good health.
The perforation was well circumscribed. The thoraco-abdominal X-ray showed a pneumoperitoneum and a sigmoid perforation. The patient was given antibiotics Cefotaxime 100 mg/kg daily divided into two doses and metronidazole 15 mg/kg stat. An enema was administered to confirm the presence of intestinal perforation. Surgery was performed on the patient on day four. The surgical exploration revealed a perforation in the posterior portion of the sigmoid colon.
The newborn’s abdomen was perforated at the rectum, and her sigmoid colon was covered with feculent material. The sigmoid colon contained a 0.4 x 0.3 cm defect, and the left colon contained a 4.5 x 3.6 x 1.1 cm mass. Pathology analysis of the specimens revealed a sigmoid colon adenocarcinoma with poorly differentiated atypia.
A perforation in the sigmoid colon is rare, with only two cases reported in pediatric patients. The majority of patients presenting with this condition have chronic constipation. In children, however, the presence of perforation is not always a primary diagnosis and should be suspected with a broad differential diagnosis.
In newborns, perforation of the sigmoid colon can be a symptom of an underlying medical condition. Most cases occur during the newborn period and are accompanied by abdominal distention and delayed passage of meconium. If a child has this disorder, they should be evaluated by a gastroenterologist.