Cecal fecaloma: A rare cause of right lower quadrant pain

Wang, Brian T.; Lee, Stefanie Y.

doi:10.1016/j.ejro.2019.03.006

Cited by 5 publications

(9 citation statements)

References 9 publications

(19 reference statements)

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“…Fecal impaction is a pseudotumor made of impaction of stool accumulated more or less dehydrated in the colonic and rectal lumen, it is rarely a cause of acute intestinal obstruction [1] [2]. The diagnosis of fecal impaction should prompt the search for these potential multiple causes described in the literature [4] [5].…”

Section: Discussionmentioning

confidence: 99%

An Inahbitual Etiology of Acute Intestinal Obstruction: The Giant Fecalome

Ismaèl¹,

M²,

Bernadette³

et al. 2023

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The authors report an observation of a 20-year-old patient, who was referred by the medical emergency department for abdominal distention. The disease would have started with the appearance of abdominal pain, a stop of materials without stopping gases appeared gradually and evolving for 4 months. The patient was chronically constipated. She administered daily enemas with homemade products to have a bowel movement. She never had rectal bleeding, there was no alteration diarrhea-constipation. Mother of 3 children alive and apparently healthy. On clinical examination the abdomen was enlarged in size, painless but of firm consistency. The hernial orifices were free. Hard and abundant stools were noted on digital rectal examination. The abdominal CT scan revealed a large endorectal fecal impaction going up into the left colon, an absence of abdominal mass. We retained the diagnosis of giant fecal impaction. The patient was hospitalized and we instituted paraffin oil therapy combined with an evacuator enema with glycerin. The evolution was marked by a resumption of transit in the form of stool and gas (3 to 4 stools per day). At Day 8 of hospitalization the abdomen had decreased in volume the transit was regular and the patient was discharged on Day 10. Reviewed 3 months later, she maintained a regular transit made of one bowel movement a day. After a setback of 3 years the transit is still preserved. The authors discuss the etiologies of fecal impaction and their respective treatments.

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Section: Discussionmentioning

confidence: 99%

An Inahbitual Etiology of Acute Intestinal Obstruction: The Giant Fecalome

Ismaèl¹,

M²,

Bernadette³

et al. 2023

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“…Cecal and small bowel localizations are rarely reported. 6,7 Fecaloma is typically seen in elderly patients, particularly in those bed bound and institutionalized and more common in women. [3][4][5] Chronic constipation, frequently seen in elderly and bedridden patients, plays an important role in the development of fecaloma 1,3,4,8 Other common risk factors reported in the literature were neuropsychiatric diseases and use of constipating medication like antiepileptic, antidepressant and opioid therapy.…”

Section: Discussionmentioning

confidence: 99%

Case Report: A giant fecaloma revealed by severe aspiration pneumonia and urinary retention

et al. 2021

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Fecaloma is an accumulation of hardened impacted stool typically occurring in the sigmoid colon and rectum. It mainly affects elderly and bedridden patients suffering from chronic constipation and can be revealed by different signs. We report a case of 74-year-old female, with anorexia, Alzheimer’s disease, and chronic constipation, who was admitted to the emergency department with complaints of dyspnea and anuria. Clinical examination showed fever, Glasgow Coma Scale score of 13/15, tachycardia with a blood pressure of 100/50 mmHg, polypnea with hypoxia, foci of crepitant rales in pulmonary auscultation and a tender hypogastric mass with mild diffuse abdominal tenderness. Digital rectal examination revealed hard fecal material. Computed tomography (CT) images demonstrated bilateral pulmonary parenchymal condensation and a huge heterogeneous fecaloma in the sigmoid colon and rectum compressing the bladder. Based on these findings, the diagnosis of giant fecaloma causing aspiration pneumonia and urinary retention was retained. Manual disimpaction and bowel enemas were done but they were unsuccessful and surgical treatment was refused. Ultimately the patient died due to septic shock. Early diagnosis should be made to relieve symptoms and prevent complications.

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“…Regarding the treatment of fecalomas in the rectosigmoid area, conservative procedures such as bowel rest, laxatives, enemas, manual evacuation, and colonic lavage are commonly adopted [ 1 – 3 ]. However, especially in the case of a fecaloma in the proximal colon or small intestine, endoscopic disimpaction or surgical intervention may be required [ 6 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are multiple causes of fecaloma formation, but in our case, the cause was not immediately evident as the patient had no reported history of altered bowel habits. Chronic constipation is a common problem that can lead to fecal impaction and even the development of fecalomas [ 1 – 4 ]. Other diseases which reported to result in fecalomas include Hirschsprung's disease, Chagas disease, psychiatric disorders, intestinal tuberculosis, and scleroderma [ 3 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction

Kanai

Nakaya

Fukumoto

et al. 2021

Case Reports in Pediatrics

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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. As the fecalomas could not be resolved by laxatives, enemas, or colonic lavage, endoscopic disimpaction under general anesthesia was attempted. Repeatedly shaving the fecalomas with biopsy forceps finally resulted in gradual fragmentation with subsequent passage. Gastrointestinal food allergy was later suggested as the cause because eosinophilic infiltration was found in a biopsy specimen of the colon wall. Endoscopic disimpaction is an effective treatment approach for addressing fecalomas to avoid more invasive surgical intervention.

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Cecal fecaloma: A rare cause of right lower quadrant pain

Cited by 5 publications

References 9 publications

An Inahbitual Etiology of Acute Intestinal Obstruction: The Giant Fecalome

An Inahbitual Etiology of Acute Intestinal Obstruction: The Giant Fecalome

Case Report: A giant fecaloma revealed by severe aspiration pneumonia and urinary retention

Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction

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