Bilateral Hydronephrosis Due to Fecaloma in an Elderly Woman

Abstract

By computer search of the literature, we found few cases of hydronephrosis due to fecal impaction. Because such a complication is extremely rare, we describe an 81-year-old woman with dementia, gallstones, arterial hypertension, and diverticulosis of the sigma who was hospitalized for severe constipation, fecaloma, and bilateral hydronephrosis. Through simultaneous lavage by two rectal tubes and manual disimpaction of fecaloma, bilateral hydronephrosis was resolved. We also briefly review the appropriate literature.

Obstructive Uropathy Caused by Chronic Constipation

“…In the literature, we found several cases of asymptomatic uropathy due to constipation. Our case and eight other cases, had no abdominal symptoms and showed no signs of distress, despite a grossly distended abdomen (3,11,12,(21)(22)(23)(24)(25). Of these, eight had an underlying history of psychosis, dementia, diabetes mellitus or cerebrovascular disease.…”

A Case of Fecaloma

“…Fecalomas are common in Hirschsprung's disease, Chagas disease, inpatients with spinal injuries, behavioral abnormality, and in elderly patients with chronic constipation [2]. Complications of fecaloma include intestinal obstruction, colonic ulceration, stercoral perforation and hydronephrosis due to mass effect [3,4]. Treatment options include use of enema, laxatives, and rectal evacuation to relieve fecal impaction and surgical intervention if conservative methods fail.…”

Troubles sensitifs périnéaux par compression sacrée secondaire à un fécalome géant

“…Les complications des fécalomes géants sont rares [7][8][9][10][11][12][13]. Si des incontinences urinaires, des tamponnades cardiaques, des compressions urétérales et des hydroné-phroses ont été décrites, une compression nerveuse n'a, à notre connaissance, jamais été signalée.…”