To the Editor.—
Lipschutz and Easterling1 have recently noted that although spontaneous perforation of the colon in the absence of diverticulitis is extremely rare, they have observed two such cases and cite the report of a third2 in patients with polycystic kidney disease. I have encountered a fourth.
Report of a Case.—
A 35-year-old man was first seen at UCLA Hospital in March 1962, with the established diagnosis of polycystic kidney disease. His mother and maternal grandmother were known to have died of the disease. He was chronically ill and anemic; his liver was moderately enlarged, firm and nontender. He had large, irregular, nontender masses in both kidney areas. Serum creatinine level was 19 mg/100 ml; blood urea nitrogen, 182 mg/100 ml; and hematocrit, 39%. He underwent hemodialysis once (long-term facilities were not yet available) and he was discharged much improved symptomatically. Hospitalization was repeated for single dialysis