Bowel perforation due to chronic idiopathic megacolon: Case report and literature review
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Updated: Oct 5, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Mauro Giambusso1, Pietro Fransvea1, Gilda Pepe1
1Emergency Surgery and Trauma - Fondazione Policlinico "A. Gemelli" IRCCS, Rome, Italy; Catholic University of Sacred Heart, Rome, Italy.
Introduction And Importance:
Chronic idiopathic megacolon is a rare condition characterized by an irreversible distension of the colon in the absence of organic disease. The pathogenesis of this condition is still unclear and the data in literatures are not consistent.
Case Presentation:
We report a case of an 87-years-old woman affected by bowel perforation in chronic idiopathic megacolon. The patient underwent an emergency subtotal colectomy with terminal ileostomy. The postoperative was uneventful. At the histopathological examination, no organic cause of megacolon was found, so a diagnosis of idiopathic megacolon was done.
Clinical Discussion:
Idiopathic megacolon is difficult to diagnose due to the lack of specific clinical manifestations and pathological features. If not carefully investigated, can lead to severe complications such as perforation of the dilated bowel and subsequent peritonitis and sepsis, metabolic and electrolyte abnormalities. The protocols for management of IMC remains controversial. To achieve a good long-term outcome, early intervention is recommended.
Conclusion:
Early diagnosis of idiopathic megacolon is needed to perform the best therapeutic strategy and prevent complications, but further studies are needed.
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