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The intraoperative findings, histology, and subsequent colonoscopy did not reveal any underlying cause for the perforation. Clinical signs and symptoms are generally absent in patients following spinal cord injury, and the diagnosis of serious gastrointestinal pathology can be difficult and challenging. We believe that ischemia at the rectosigmoid junction precipitated by multiple factors was the possible reason for the spontaneous perforation. Clinical signs and symptoms are generally absent in patients following spinal cord
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