Introduction: Acute abdomen is common surgical problem that usually needs surgical intervention. Wide range of etiologies that lead to acute abdomen. Bowel injury or perforation is one of these leading causes, that usually because of trauma (blunt, penetrating and iatrogenic) or perforation of diseased bowel.
Case presentation: A 27 years old male patient with no previous medical or surgical history, presented to emergency complaining of severe abdominal pain for one day. Examination revealed severe tenderness and rigidity all over the abdomen. CT abdomen revealed large amount of free fluid in abdomen. Diagnostic laparoscopy done showed large amount of hemo peritoneum with big hematoma over sigmoid colon associated with multiple serosal lacerations of sigmoid colon. Suction of blood done with drain insertion in the pelvis. Post-operative period was smooth patient discharged home 2 days after surgery without complain.
Discussion: Colonic injury that causes acute abdomen is usually complete injury that leads to fecal peritonitis. Here we presented a novel scenario of spontaneous serosal lacerations in healthy colon that led to massive hemo peritoneum and acute abdomen. potential etiologies are persistent constipation, low fiber dietary habits that cause increase of intra colonic pressure and presence of connective tissue disorders.
Conclusion: Spontaneous colonic serosal lacerations should be added to the differential diagnosis of acute abdomen. Laparoscopic exploration is of great value in acute abdomen.
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