-Case Reports-

Seromuscular Tear of the Sigmoid Colon in the Absence of Trauma: A Case Report

Tsutomu Nomura, Masao Miyashita, Itsuro Fujita, Hideyuki Suzuki, Kiyonori Furukawa and Takashi Tajiri

Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School

A 16-year-old adolescent boy was admitted to our hospital with severe lower abdominal pain and was found to have peritonitis, probably caused by acute appendicitis. At laparotomy, we found a paper-thin, dilated sigmoid colon; the seromuscular layer on the antimesenteric side was torn, and the untorn mucosa showed a pinpoint perforation. The seromuscular defect had spread circumferentially to involve the entire circumference of the colon wall. We performed sigmoidectomy, and the patient recovered uneventfully. This case showed many similarities, both in terms of the macroscopic and pathological findings, to seromuscular tear, an entity specifically associated with seatbelt use. This case is noteworthy because seromuscular tear-like lesions of the colon without a history of trauma has not previously been reported.

J Nippon Med Sch 2008; 75: 289-292

Keywords
seromuscular tear, intraluminal dissociation of intestine, spontaneous perforation of colon

Correspondence to
Tsutomu Nomura, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
nomura-t@nms.ac.jp

Received, April 25, 2008
Accepted, May 23, 2008