An otherwise healthy 59-year-old man presented to the emergency department with 2 weeks of narrowed stools, 5 days of obstipation, and 1 day of abdominal pain, nausea, and vomiting. Computed tomography revealed an obstructing sigmoid mass without evidence of metastatic disease, and the CEA was 1.2 ng/mL. Flexible sigmoidoscopy confirmed a circumferentially obstructing distal sigmoid neoplasm. Endoscopic stent placement was immediately followed by a firm distended abdomen. An upright radiograph obtained following the procedure demonstrated free intraperitoneal air. An emergent Hartmann procedure was performed for iatrogenic colon perforation in a patient with malignant obstruction and chronic dilation of the proximal colon.
1 Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor, Michigan
2 Center for Colon and Rectal Surgery, Advent Health, Orlando, Florida
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Funding/Support: None reported.
Financial Disclosures: None reported.
Correspondence: June Hsu, M.D., M.P.H., Saint Joseph Mercy Ann Arbor Hospital, 1414 Astor Ave, Ann Arbor, MI 48104. E-mail: firstname.lastname@example.org