HISTOLOGY REPORT
Specimen: Sigmoid colon.
Clinical Details: Laparotomy and Hartmann's for perforated sigmoid colon. Faecal peritonitis.
Macroscopic: 240mm length of large bowel full of impacted faeces. Perforation site 100 mm from nearest margin.
Microscopic: At the site of perforation there is an area of acute transmural ischaemic necrosis of the large bowel wall with inflammation in the adjacent fat and an inflammatory serosal reaction. Vessels are congested but there is no vasculitis and no diverticula are noted. Sampling from the mesentery shows weakly reactive lymph nodes and congested vessels. There is no vascular occlusion. One resection margin is suboptimally orientated but the other shows no significant pathology.
Conclusion: Sigmoid colectomy - perforated sigmoid colon with faecal impaction (stercoral perforation).