Spontaneous colonic rupture related to the segmental absence of muscularis propria in an adult

Chih‑En Tseng^a,b, Shih‑Pin Lin^c, Hou‑Chi Huang^d, Mei‑Chung Chin^a*

^aDepartment of Anatomic Pathology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, ^bSchool of Medicine, Tzu Chi University, Hualien,
Taiwan, ^cDepartment of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, ^dDepartment of Radiology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

Abstract
Colonic perforation is a medical emergency that may be fatal if surgery cannot be performed in a timely manner. Colonic rupture in adults is caused by primary (idiopathic) and secondary factors. Although the segmental absence of muscularis propria (SAMP) is a recognized cause of secondary colonic rupture in neonates and infants, few cases have been reported in adults. Here, we present the case of a large colonic rupture caused by SAMP in a 60‑year‑old woman and a review of the literature. We suggest that SAMP should be included in the differential diagnosis of large perforation and/or periperforation membranous thinning of the colonic wall in adults.

Keywords: Colonic perforation, Colonic rupture, Perforation of small intestine, Segmental absence of muscularis propria, Segmental muscular defect of intestine