{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:10:09Z","timestamp":1756311009668,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,13]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>A 63-year-old man with a history of gastro-oesophageal reflux disease underwent defunctioning loop ileostomy for obstructing metastatic rectal cancer prior to receiving long-course neoadjuvant chemoradiotherapy. Four months post completion of neoadjuvant therapy, he underwent an uncomplicated elective ultra-low anterior resection with formation of colonic J pouch and first stage liver metastasectomy for bilobar liver disease. At 1\u2009year, he proceeded to an elective closure of loop ileostomy. Unfortunately, his postoperative course was complicated by profuse diarrhoea with subsequent colonic perforation, necessitating an emergency laparotomy and ileocolic resection with end ileostomy formation. Histopathology and stool studies were consistent with <jats:italic>Salmonella<\/jats:italic> Typhi infection. At the present time, <jats:italic>Salmonella<\/jats:italic> Typhi causing toxic megacolon and subsequent colonic perforation is an uncommon phenomenon in Australia. Here, we present an unusual case and explain why bowel perforation in this instance likely had a multifactorial aetiology.<\/jats:p>","DOI":"10.1136\/bcr-2019-229961","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T07:35:21Z","timestamp":1567236921000},"page":"e229961","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["An unusual case of caecal perforation following ileostomy reversal"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6668-0657","authenticated-orcid":false,"given":"Gamze","family":"Aksakal","sequence":"first","affiliation":[{"name":"Department of Surgery, Eastern Health, Box Hill, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suat","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Vincents Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinna","family":"An","sequence":"additional","affiliation":[{"name":"Department of Surgery, Eastern Health, Box Hill, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,30]]},"reference":[{"key":"2025082708380881000_12.8.e229961.1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1985.00360110196039"},{"key":"2025082708380881000_12.8.e229961.2","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1007\/s12098-013-1115-7","article-title":"Unusual complication of toxic megacolon in typhoid colitis","volume":"81","author":"Arun Babu","year":"2014","journal-title":"Indian J Paediatr"},{"key":"2025082708380881000_12.8.e229961.3","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800660104"},{"key":"2025082708380881000_12.8.e229961.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-001-0374-3"},{"key":"2025082708380881000_12.8.e229961.5","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.18203\/2349-2902.isj20182080","article-title":"Typhoid ileal perforation: a two-year study at a tertiary care hospital of South India","volume":"5","author":"Markapuram","year":"2018","journal-title":"International Surgery Journal"},{"key":"2025082708380881000_12.8.e229961.6","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1007\/s12291-012-0187-x","article-title":"Role of nitric oxide in salmonella infection","volume":"27","author":"Ghosh","year":"2012","journal-title":"Indian J Clin Biochem"},{"key":"2025082708380881000_12.8.e229961.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.tim.2014.06.007"},{"key":"2025082708380881000_12.8.e229961.8","first-page":"806","article-title":"Searching for salmonella","volume":"37","author":"Darby","year":"2018","journal-title":"Aust Fam Physician"},{"key":"2025082708380881000_12.8.e229961.9","doi-asserted-by":"crossref","first-page":"e0006215","DOI":"10.1371\/journal.pntd.0006215","article-title":"Diagnostic metabolite biomarkers of chronic typhoid carriage","volume":"12","author":"N\u00e4sstr\u00f6m","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"2025082708380881000_12.8.e229961.10","first-page":"276","article-title":"Complications after loop ileostomy closure: a retrospective analysis of 132 patients","volume":"30","author":"Poskus","year":"2014","journal-title":"Viszeralmedizin"},{"key":"2025082708380881000_12.8.e229961.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198901053200105"},{"key":"2025082708380881000_12.8.e229961.12","doi-asserted-by":"publisher","DOI":"10.1007\/BF02051922"},{"key":"2025082708380881000_12.8.e229961.13","doi-asserted-by":"crossref","first-page":"542","DOI":"10.3748\/wjg.v19.i4.542","article-title":"Relationship between diversion colitis and quality of life in rectal cancer","volume":"19","author":"Son","year":"2013","journal-title":"World J Gastroenterol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229961","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:38:20Z","timestamp":1756309100000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229961"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,8,30]]},"published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1136\/bcr-2019-229961"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229961","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}