sepsis due to faecal peritonitis due to suture failure of bowel anastomosis following right hemi-colectomy due to carcinoma of the colon
AI-generated summary
An 82-year-old man died from sepsis due to faecal peritonitis following anastomotic breakdown after right hemi-colectomy for colon cancer. Surgery was appropriate and proceeded without incident. Five days post-operatively, he developed symptoms of bowel leak (hiccoughing, abdominal distension, vomiting, confusion) but diagnosis was delayed because he lacked typical sepsis markers (normal white cell count, afebrile). His polycythaemia and advanced age likely compromised wound healing. CT scan eventually revealed contained leak with gas; drainage was attempted but laparotomy showed extensive anastomotic breakdown requiring washout. Despite ICU support, he deteriorated with septic shock and multi-organ failure. The coroner found no criticism of the diagnostic delay given atypical presentation, though earlier recognition would have improved survival prospects.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.
colonic carcinomaanastomotic leakbowel perforationsepsisseptic shockfaecal peritonitisileusatrial fibrillationpolycythaemiamultiple organ failure
Procedures
right hemi-colectomylaparoscopic hemicolectomynaso-gastric tube insertionCT scan abdomenultrasound-guided drain placementlaparotomyaspiration and lavage of faecal collection
Contributing factors
anastomotic breakdown and leakage
advanced age compromising wound healing
polycythaemia affecting healing capacity
atypical presentation of sepsis without fever or elevated white cell count making diagnosis difficult
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