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Chronic colonic perforation in pseudomyxoma peritonei

Department of Radiology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK

Correspondence: Dr Leena Naidu, Department of Radiology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK. E-mail: srinaidu{at}hotmail.com

Pseudomyxoma peritonei (PP) produces abundant mucoid material from the rupture of low grade ovarian or appendiceal mucinous tumours. The unique pattern of cancer dissemination and intraperitoneal mucous re-distribution makes it a distinct clinical condition. It has diverse presentations, mainly as a result of narrowing of the gastrointestinal tract and entrapment of other viscera by gelatinous mucoid material. Imaging is helpful, but not diagnostic of this condition. We report a patient with pseudomyxoma perotonei who had perforation at the recto-sigmoid junction into a large mucinous cyst adjacent to the sigmoid colon. The patient improved clinically with conservative management, with persisting communication and no adverse symptoms reported at 4 months follow-up.