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Sept 7, 1963

Recurrent Spontaneous Rupture of the Bowel Manifested by Hemoperitoneum

JAMA. 1963;185(10):808. doi:10.1001/jama.1963.03060100088033

To the Editor:—  Spontaneous rupture of the normal bowel is a rare event. Perforation of the normal colon is less frequent than rupture of the small intestine. In a recent article, Noussias1 reports two cases of ruptured large intestine and discusses 34 other cases from the literature, 22 of them without apparent associated muscular straining. All of these had a complete rupture of the intestinal wall.Hemoperitoneum as a presenting feature with partial rupture of the colon has been reported only once, as far as we can determine. Howe2 reports a case with partial rupture after severe straining at stool. The wall of the sigmoid flexure showed a rupture of the serosa and muscularis, with the mucosa remaining intact.Our case has several unusual features: It is the only reported case with primary resection, the youngest reported case, and the only case with a recurrence.

Case Report.—  A