A Case of Rectal Cancer with Perforation Caused by a Trans-Anal Decompression Tube Being Pulled Out by the Patient Himself

• Published in: Nippon Daicho Komonbyo Gakkai Zasshi Vol. 64; no. 3; pp. 159 - 163
• Main Authors: Hamasaki, Keiko, Nakazaki, Takayuki, Fukuoka, Hidetoshi, Akama, Fumitaka
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Coloproctology 2011
• Subjects: a trans-anal decompression tube; rectal cancer; rectal perforation
• ISSN: 0047-1801; 1882-9619
• DOI: 10.3862/jcoloproctology.64.159

A 73-year-old man visited a hospital complaining of constipation. Abdominal CT showed wall thickening of the rectum and dilatation of the oral-side intestine, suggesting rectal cancer. A trans-anal decompression tube was inserted on that day, but during the night he pulled the tube out by himself. He then suffered strong abdominal pain, and so the tube was inserted again. Abdominal CT revealed perforation of the rectum. Although he was brought to our hospital by ambulance, he was in shock. We performed Hartmann's operation on him. His abdominal cavity was filled with stool and the tube was exposed from the anterior wall of the Rs part of the rectum. A type-2 tumor of 60×47mm was sited in the same area. The histopathological diagnosis was well-differentiated tubular adenocarcinoma. There have been case reports of perforation caused by a trans-anal decompression tube, but our case is very rare.