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December 1959

Impending Cecal Perforation Secondary to a Crushing Injury of the Pelvis

Author Affiliations

Harrisburg, Pa.
Chairman, Department of Surgery, Harrisburg Hospital (Dr. Moore); Assistant Resident, General Surgical Service (Dr. Koman), Harrisburg Hospital.

AMA Arch Surg. 1959;79(6):1044-1046. doi:10.1001/archsurg.1959.04320120186026

The purpose of this article is to report a case of adynamic ileus of such severity that the alarming distention of the cecum induced us to perform a cecostomy. The operative findings, substantiated by the final pathologic report, would indicate that, without surgical intervention, perforation of the cecum, with its alarming high mortality, would assuredly have occurred. Roentgenographic studies relating the greatest cecal diameter to impending cecal perforation pertain to ileus secondary to obstructing lesions of the colon distal to the cecum. In the cases reviewed by Davis and Lowman, 9 cm. is cited as the critical dimension beyond which cecal perforation was liable to occur. Eckman, Wenzke, and Abramson have recently reported a case of adynamic ileus in an elderly woman resulting in cecal perforation and her death. The greatest cecal diameter in their case was 9 cm. Their review of the recent literature indicated no other case reports