Sigmoid and Rectosigmoid Colon Perforation with Swallowed Santol SeedChaoprayayomraj Hospital

Abstract

From 1993 to 2007, of the patients operated in Chaoprayayomraj Hospital because of the sigmoid and rectosigmoid colon perforation, there were twenty five cases having santol seeds in their perforated bowels.  The objective of this study was a preliminary attempt to find out background data leading to bowel perforation in these cases. In first diagnoses, peritonitis dominated in 60 percent of them and 8 patients underwent colon resection and proximal loop colostomy.  As a result 3 hypotheses emerged : (1) stercoral perforation, (2) sudden increasing of pressure in the bowel lumen, and (3) predisposing by the underlying or the associated inflammatory process.  It was difficult to make correct diagnosis of this disease, preoperatively.  The treatment of this disease was similar to the treatment of the other colo-rectal injuries.  There were many factors influencing the decision for operations, such as the patientsี general  conditions, the degree of severity of the contamination in the peritoneal cavity and the experiences of the surgeons.  Santolีs products come out only in April to July annually and health education may be required to avert such possibly harmful incidents and related complications.