Spontaneous colonic perforation in adults (SCPA) is rare but important. Its clinicopathological features and outcomes remain unclear. Therefore, the aim of the current study was to explore and investigate the clinicopathological characteristics, clinical outcomes and potential risk factors for patients with SCPA. Data of seven patients with SCPA treated in our hospitals from January 2008 to December 2017, and 221 cases from research databases before 2018 were retrospectively analyzed. The description of SCPA included stercoral perforation of the colon (SPC), idiopathic perforation of the colon (IPC) and spontaneous colonic perforation (SCP) in the study. All SCPA patients presented with unexplained abdominal pain and peritonitis. The median age was 62.5 years. The definite diagnosis preoperatively was 20.6%. The commonest lesion location was sigmoid colon and Hartmann’s operation accounted for 59.3%. Histopathology of stercoral perforation (HSP) and histopathology of idiopathic perforation (HIP) were two histopathological findings. Postoperative complication was 67.7% and mortality was 31.1%. Univariate and multivariate analyses showed that chronic constipation was an independent risk factor for histopathological features (p ≤ 0.001, p = 0.005). Age of patients was associated with both postoperative complication (p = 0.012, p = 0.044) and mortality (p = 0.013, p = 0.034). Univariate analysis showed that HSP was associated with postoperative complication (p = 0.015). Our findings from the analysis pertaining to SCPA confirm those from previous studies, supporting the SCPA, as a uniform description, is an infrequent and life-threatening disease requiring early surgical intervention. We found that the elderly with chronic constipation was a high-risk category and those with HIP had a more favorable outcome than that of patients with HSP.

成人自发性结肠穿孔（SCPA）很少见，但很重要。其临床病理特征和结果仍不清楚。因此，本研究的目的是探讨和调查 SCPA 患者的临床病理特征、临床结局和潜在危险因素。回顾性分析2008年1月至2017年12月在我院收治的7例SCPA患者的数据以及2018年之前研究数据库中的221例病例。研究中对 SCPA 的描述包括粪结肠穿孔 (SPC)、特发性结肠穿孔 (IPC) 和自发性结肠穿孔 (SCP)。所有 SCPA 患者均出现不明原因的腹痛和腹膜炎。中位年龄为 62.5 岁。术前确诊率为20.6%。最常见的病变部位为乙状结肠，Hartmann手术占59.3%。粪穿孔（HSP）的组织病理学和特发性穿孔（HIP）的组织病理学是两种组织病理学发现。术后并发症发生率为67.7%，死亡率为31.1%。单变量和多变量分析显示，慢性便秘是组织病理学特征的独立危险因素（p≤0.001 ，p  =0.005）。患者年龄与术后并发症（ p  = 0.012，p  = 0.044）和死亡率（p  = 0.013，p  = 0.034）相关。单变量分析显示HSP与术后并发症相关（p  = 0.015）。我们对 SCPA 的分析结果证实了之前的研究结果，支持 SCPA 作为一种统一的描述，是一种罕见且危及生命的疾病，需要早期手术干预。我们发现患有慢性便秘的老年人是一个高危人群，并且患有HIP的患者比HSP患者的预后更好。