Altered Mental Status as the Primary Presentation of Stercoral Colitis

Himax, Patel; Anna, M. Piskorz; Ali, Amghaiab Idris F

doi:10.23937/2469-584x/1510083

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…In the ED, SC is typically a radiologic diagnosis. While it should be considered in any patient with chronic constipation and abdominal pain, clinical diagnosis is made challenging by the fact that patients often present with vague signs and symptoms, or they may be altogether asymptomatic [ 1 – 4 ]; in fact, recent literature has reported that 60% of SC patients in the ED denied any abdominal pain [ 5 ]. Computed Tomography (CT) imaging and clinical intuition are therefore critical to the diagnosis of SC, and several studies have described radiologic findings important for the detection of SC and its complications.…”

Section: Introductionmentioning

confidence: 99%

Stercoral colitis in the emergency department: a review of the literature

Bae,

Tran,

Shah

2024

Int J Emerg Med

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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. Discussion SC primarily occurs in elderly or bedbound patients with chronic constipation; however, it does occur in younger patients with comorbidities at increased risk for fecal impaction. Patients may present acutely with abdominal pain and distension, but clinical presentation is often nonspecific and varied, and there are no established diagnostic criteria for SC to date. CT is therefore crucial for diagnosis, revealing key findings such as fecaloma, colonic dilatation, and fat stranding. Treatment depends on severity of illness, ranging from manual disimpaction and other conservative measures for most cases, to surgical intervention for complicated cases, such as stercoral perforation. Conclusions SC can be a challenging diagnosis in the ED, often requiring multidisciplinary collaboration. Timely recognition and appropriate treatment are essential to reduce morbidity and mortality associated with this condition. Further research is needed to establish diagnostic criteria and clear management algorithms.

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Section: Introductionmentioning

confidence: 99%

Stercoral colitis in the emergency department: a review of the literature

Bae,

Tran,

Shah

2024

Int J Emerg Med

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“…Advanced age, dementia, chronic concomitant illness, cancer, and non-ambulatory status are all risk factors for stercoral colitis, with persistent constipation of any kind being the predominant predisposing condition [ 4 ]. Chronic neurologic and psychiatric illnesses may delay the diagnosis of SC because they hinder thorough history-taking and conceal physical examination findings [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…This is a complication of what initially appeared as simple constipation. Early identification and treatment of stercoral colitis are essential to reduce overall morbidity and mortality [ 4 ]. The incidence of SC is predicted to rise with the aging of our population; thus, clinicians need to be aware of this illness, key diagnostic tools, and treatment options [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Stercoral Colitis as a Cause of Altered Mental Status in a Patient With Cerebral Palsy

Chowdhary¹,

Liu²,

Husnain³

2022

Cureus

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Stercoral colitis (SC) is a rare inflammatory colitis that occurs due to increased intraluminal pressure from impacted fecal content in the colon. Chronic constipation is the major risk factor for this condition. Delayed diagnosis is associated with high morbidity and mortality, with complications ranging from colonic perforation to intestinal ulcers. Patients usually present with non-specific symptoms, with advanced cases presenting with acute abdomen pain. This condition can be fatal if not recognized early and promptly treated. Early detection can often be difficult in elderly patients with dementia, stroke, or other neurologic disorders that cause altered mental status (AMS). Therefore, AMS in patients with severe constipation should be a substantial reason to consider stercoral colitis as a differential diagnosis. Here, we describe a case of stercoral colitis in a 59-year-old woman with non-verbal cerebral palsy who had acute metabolic encephalopathy from her stercoral colitis and was successfully treated with colonoscopic fecal disimpaction and an aggressive bowel regimen.

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Altered Mental Status as the Primary Presentation of Stercoral Colitis

Cited by 2 publications

References 7 publications

Stercoral colitis in the emergency department: a review of the literature

Stercoral colitis in the emergency department: a review of the literature

Stercoral Colitis as a Cause of Altered Mental Status in a Patient With Cerebral Palsy

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