Abstract
Spontaneous perforation of the colon is a well documented but rare clinical entity commonly found to occur in the elderly and associated with chronic constipation. Hypothyroidism is known to be associated with intestinal motility disorders ranging from chronic constipation to more serious conditions like mega colon and pseudo obstruction. The case described here is that of a 35 years old hypothyroid male who presented with perforation peritonitis due to spontaneous perforation of the rectosigmoid. A thorough search of literature shows only one report of spontaneous perforation of the colon associated with hypothyroidism, to date. This case gives an opportunity to review the literature and discuss such unusual and dangerous presentations of hypothyroidism associated colonic motility disorders.