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July 1978

Perforation of the Colon Due to Clay Ball

Arch Surg. 1978;113(7):906. doi:10.1001/archsurg.1978.01370190128032

To the Editor.—A 40-year-old woman had acute onset of abdominal pain. The physical examination was consistent with generalized peritonitis. Chest roentgenogram showed sub-diaphragmatic air; abdominal x-ray films showed radiopaque material in the bowel and two radiopaque masses in the pelvis. Findings on exploratory laparotomy included free feces, gravel and grass blades in the peritoneal and pelvic cavity, plus two rounded masses of clay containing grass blades and gravel. The largest mass measured 6 cm in diameter. There was a 5-cm perforation of the left colon that was exteriorized as loop colostomy. The abdomen was closed with one layer of monofilament wire after irrigation and drainage were completed.

After a tormentous postoperative course, complicated with sepsis and wound abscesses requiring two weeks of intensive supportive treatment, the patient's condition started to improve. Her abdominal wound healed subsequently. Eight weeks after the initial procedure, the colostomy was closed, and patient was

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