PT  - JOURNAL ARTICLE
AU  - Gamze Aksakal
AU  - Suat Ng
AU  - Vinna An
TI  - An unusual case of caecal perforation following ileostomy reversal
AID  - 10.1136/bcr-2019-229961
DP  - 2019 Aug 01
TA  - BMJ Case Reports
PG  - e229961
VI  - 12
IP  - 8
4099  - http://casereports.bmj.com/content/12/8/e229961.short
4100  - http://casereports.bmj.com/content/12/8/e229961.full
SO  - BMJ Case Reports2019 Aug 01; 12
AB  - A 63-year-old man with a history of gastro-oesophageal reflux disease underwent defunctioning loop ileostomy for obstructing metastatic rectal cancer prior to receiving long-course neoadjuvant chemoradiotherapy. Four months post completion of neoadjuvant therapy, he underwent an uncomplicated elective ultra-low anterior resection with formation of colonic J pouch and first stage liver metastasectomy for bilobar liver disease. At 1 year, he proceeded to an elective closure of loop ileostomy. Unfortunately, his postoperative course was complicated by profuse diarrhoea with subsequent colonic perforation, necessitating an emergency laparotomy and ileocolic resection with end ileostomy formation. Histopathology and stool studies were consistent with Salmonella Typhi infection. At the present time, Salmonella Typhi causing toxic megacolon and subsequent colonic perforation is an uncommon phenomenon in Australia. Here, we present an unusual case and explain why bowel perforation in this instance likely had a multifactorial aetiology.