Fecaloma

Stercoral colitis is an uncommon inflammatory condition primarily affecting individuals with chronic constipation, immobilization, and advanced age, occasionally manifesting in pediatric patients. It arises from the accumulation of impacted fecal matter, leading to colonic distension and subsequent fecaloma formation, culminating in pressure necrosis and perforation. Mortality rates can exceed 60% in vulnerable populations due to complications such as colonic perforation and ischemia. Presented is the case of a 14-year-old female with stercoral colitis, initially presenting with diarrhea, abdominal pain, and metabolic acidosis...

A stercoral rectal perforation is an uncommon cause of acute abdominal pain with only limited cases documented in medical literature. Timely and accurate imaging is essential when this condition is suspected, and immediate surgical intervention is imperative upon confirming the diagnosis of bowel perforation. Usually, the definitive diagnosis of a stercoral rectal perforation is established intraoperatively and a Hartmann procedure with (temporary) end colostomy is performed. In this case report, we present our first-hand experience in managing a stercoral rectal perforation, highlighting the importance of early diagnosis and rapid surgical intervention to achieve favorable outcomes...

BACKGROUND: Stercoral colitis (SC) is a rare but potentially life-threatening inflammatory colitis caused by the accumulation of impacted fecal material. Despite reported associations with bowel perforation and high mortality rates, stercoral colitis remains a poorly defined and underrecognized diagnosis in the emergency department (ED). OBJECTIVE OF THE REVIEW: This review aims to summarize and synthesize existing literature on SC to guide its recognition and management in the ED...

INTRODUCTION AND IMPORTANCE: Upper thoracic fracture-dislocation following posterior instrumentation and fusion is rare, with potentially devastating neurologic consequences. The recommended treatment is an open reduction, spinal cord decompression, and a proximal extension of spinal instrumentation. To report the diagnosis and management of an acute non-traumatic T1-T2 fracture-dislocation, occurring in the early postoperative course of a posterior instrumentation and fusion for neurogenic scoliosis...

A fecaloma is a rare complication of chronic constipation that is more commonly seen in elderly individuals with chronic neuropsychiatric disorders. We present the case of a 79-year-old patient with Parkinson's disease with refractory constipation due to a large fecaloma mass in the sigmoid colon, which is a rare sequela of poorly managed chronic constipation. The current report highlights the importance of aggressive medical therapy for chronic constipation in this group of patients to prevent life-threatening complications...

Stercoral colitis, although rare, remains a significant cause of acute colonic inflammation. It is characterized by the presence of fecaloma leading to fecal impaction and subsequent mucosal injury, ultimately resulting in colonic wall inflammation. This condition primarily affects elderly patients with chronic constipation and is associated with significant morbidity and mortality if not recognized and managed promptly. Given its rarity and varied presentation, stercoral colitis often poses a diagnostic challenge...

Stercoral colitis is a rare entity of inflammatory colitis with high morbidity and mortality attributable to colonic fecaloma impaction, often a result of chronic constipation. Despite demographic imbalance favoring elders, children hold comparative risk factors for chronic constipation. Suspicion for stercoral colitis is warranted in nearly every stage of life. Computerized tomography (CT) is diagnostic for stercoral colitis, where radiological findings correlate to high sensitivity and specificity. Difficulty exists discerning from other acute and chronic intestinal etiologies with overlapping nonspecific symptoms and laboratory markers...

Colonic impaction due to a fecaloma is a very frequent complication in patients with chronic constipation. Most cases respond to conservative measures such as digital disimpaction or treatment with oral laxatives and enemas. However, in some cases fecalomas could be refractory to these treatments requiring aggressive measures such as endoscopic or surgical removal. Even more, there are a few cases of death reported as a complication of a fecaloma refractory to usual treatments. We report, for the first time, a case of a patient with a huge fecaloma refractory to oral laxative and enemas resolved conservatively with a single irrigation of a carbonated soft drink through a rectal probe...

A nine-year-old wheelchair-bound female with cerebral palsy and intellectual disability secondary to trafficking protein particle complex subunit 9 ( TRAPPC9 ) mutation presented to the family medicine clinic after not having passed stool for six days. There was a history of chronic constipation. Examination revealed high-pitched "tinkling" bowel sounds; therefore, a plain abdominal X-ray was ordered to rule out the possibility of intestinal obstruction, which showed a large fecaloma in the rectum with dilated bowel loops proximal to it, signifying obstruction...

Fecalomas most commonly occur in constipated patients and are rarely reported after colectomy. A 55-year-old Japanese female presented with a fecaloma after colectomy, which was impacted at a functional end-to-end anastomosis (FEEA) site. Four and a half years ago, she underwent sigmoidectomy for colon cancer. A follow-up computed tomography (CT) scan revealed an 11 cm incidental fecaloma. The patient was advised to undergo surgery, but she desired nonoperative management because of minimal symptoms, and was referred to our institution...

Chronic constipation and fecal impaction are common in older individuals but can also be found in younger patients with cognitive and psychiatric illnesses. The diagnosis of fecal impaction and, the assessment of severity are best performed clinically. Here, we present a case of a 30-year-old autistic individual where limited history was obtainable and further imaging helped to urgently diagnose a 47 x 15.6 x 12 cm stool ball, causing significant mass effect of surrounding intra-abdominal structures. Fecal disimpaction and aggressive bowel regimen prevented the pathological effects of severe fecal retention...

Dermatomyositis (DM) is an inflammatory myopathy (IIM) characterized by proximal muscle weakness and pathognomonic skin lesions. A 69-year-old woman with a recent diagnosis of DM 1 month prior, treated with corticosteroids and immunomodulators, presented to our inpatient rehabilitation with worsening dysphagia and constipation. At the time of our evaluation, physical examination was notable for erythematous papules over the metacarpophalangeal joints, proximal interphalangeal joints, elbows, and knees as well as a violaceous rash on the face...

A 59-year-old man with a history of cerebral palsy and dextroscoliosis died in a group home. He required supplemental oxygen and had no bowel movement for weeks prior to death. At autopsy, the abdomen was markedly distended and there were flexion contractures of the legs. Postmortem computed tomography revealed a dilated digestive tract and fecal loading in the sigmoid and rectum, marked upwardly displaced diaphragm and scoliosis. On internal examination, the diaphragm was displaced rostrally and the rectosigmoid colon contained 2...

INTRODUCTION: Fecaloma is an accumulation of feces that has formed a mass and has failed to be expelled spontaneously. Because fecal matter is harder and firmer in the left side of colon, and the diameter of the bowel is smaller compared to the right, fecalomas mostly form in recto-sigmoid area. Small bowel fecaloma formation is an extremely rare condition. CASE PRESENTATION: We report a 49 years old man who presented with small bowel obstruction due to ileal fecalomas for whom enterotomy and removal of fecaloma was done with good outcome...

BACKGROUND: This report describes a rare surgical case of an intraabdominal mass in a middle-aged patient 40 years after imperforate anus repair. CASE PRESENTATION: A 44-year-old Latino male with history of repaired anorectal malformation presented with recurrent urinary tract infections and rectal prolapse with bothersome bleeding and fecal incontinence. During his preoperative evaluation, he was initially diagnosed with a prostatic utricle cyst on the basis of magnetic resonance imaging findings, which demonstrated a cystic, thick-walled mass with low signal contents that extended inferiorly to insert into the distal prostatic urethra...

Idiopathic megacolon (IMC) and idiopathic megarectum (IMR) describe an abnormality of the colon or rectum, characterised by a permanent dilatation of the bowel diameter in the absence of an identifiable cause. We present a 23-year-old woman with chronic constipation and excessive straining during defecation who presented at the emergency department in partial gut obstruction with a palpable fecaloma. Manual faecal disimpaction and a sigmoid loop colostomy was initially done. A full thickness rectal biopsy was positive for ganglion cells...

Edwards syndrome, or trisomy 18, is an uncommonly encountered aneuploidy in which multiple organs are affected and have compromised function. Only 13% of neonates born with Edwards syndrome survive beyond their first year of life. In this paper, we report the case of a 16-year-old girl with non-mosaic (with meiotic non-disjunction) Edwards syndrome who survived long beyond the expected life span of less than two years. She was diagnosed by karyotyping at the age of one month with complete trisomy 18. She had global developmental delay, a diaphragmatic hernia, recurrent chest infections, juvenile idiopathic scoliosis of the thoracolumbar region, neurogenic bladder, fecaloma, bilateral exposure keratopathy, and failure to thrive...

A fecaloma is a mass of accumulated feces with a consistency much harder than that of a fecal impaction. It is most frequently observed in the rectum and sigmoid area, and associated complications include colonic obstruction, ulceration, bleeding, and perforation. A one-year-old, previously healthy boy with no history of chronic constipation was admitted because of vomiting and abdominal distension. An abdominal computed tomography scan showed small and large bowel distension due to multiple obstructive fecalomas in the transverse colon...

Hydroureteronephrosis with acute urinary tract obstruction can lead to serious complications such as obstructive nephropathy or pyelonephritis. We report the first case of hydroureteronephrosis caused by a giant fecaloma in an 83-year-old woman accompanied with chronic constipation in Korea. The patient with a fever presented to the emergency room and was diagnosed with right hydronephrosis. Computed tomography revealed a markedly dilated rectum with a giant fecaloma compressing the right vesicoureteric junction...

Stercoral perforation (SP) is a rare cause of peritonitis. It is caused by pressure necrosis of the colonic wall by fecaloma. SP is a lethal condition that is associated with high morbidity and mortality, therefore early diagnosis and treatment are of paramount importance. Herein, we describe a case of SP in a systemic lupus erythematosus (SLE) patient. A 44-year-old female, known case of SLE, presented with severe abdominal pain, fever, and hypotension. CT scan showed features of perforated sigmoid. The patient underwent exploratory laparotomy which revealed perforation of sigmoid, fecalomas in the peritoneal cavity, and colon loaded with fecal matter...