[The clinico-evolutionary and therapeutic aspects in diastatic perforation of the cecum]

We describe five cases of diastatic perforation of cecum due to colonic cancer obstruction with secondary diffuse peritonitis, all in elderly patients with many organics dysfunctions and, most important a late arrival for hospitalisation (over 48 h). The surgical treatment aimed for the perforation and the obstruction has permitted the realization--in emergency--of: cecostomy on site of perforation, with multiple peritoneal drainage; subtotal colectomy with ileosigmoid anastomosis; cecum perforation sutures, with left colostomy, opened per primam; cecostomy on site of perforation with left colostomy, drainage. We underline the severe postoperative evolution, with only one survival be cause of the fast pace evolution of toxico-septic shock by pyostercoral peritonitis due to perforation.