Journal of Emergency Medicine Case Reports

Öz

Pneumoperitoneum is the
result of a gastrointestinal (GI) tract perforation in more than 90% of cases.
Perforation of the stomach or duodenum caused by peptic ulcer is considered the
most common cause of pneumoperitoneum. In this article, we present a case of
pneumoperitoneum associated with sigmoid colon perforation, which is the result
of the patient trying to create a laxative effect by inserting the hose
attached to the wash basin into his rectum and opening the water afterwards. An 89
years old male patient was brought to the emergency department with complaints
of abdominal pain starting about 2 hours ago.
The patient's abdominal ultrasonography showed free fluid up to 10 cm in the
lower abdomen. Posterior anterior chest X-ray and direct standing abdominal X-ray of the patient had subdiaphragmatic
free air and images with free fluid, pneumoperitoneum and perforation were
obtained in contrast enhanced abdominal tomography. As a result of surgery
performed by general surgery it was seen approximately 30 cm proximal
from the rectumthat there was a 4 cm perforation
in the sigmoid colon. We must consider pneumoperitoneum, which is the result of
colon perforation especially in elderly patients with acute abdominal pain, to
be definitely among our differential diagnoses.