Giant Fecaloma Causing Large Bowel Obstruction: A Case Report

Abstract

Fecalomas are masses of hardened stool that are typically impacted in the sigmoid colon and rectum. Fecalomas are commonly associated with chronic constipation, Hirschsprung's disease, Chagas disease, and multiple psychiatric conditions. We present a case of a giant fecaloma resulting in complete large bowel obstruction and suggest a five-year abdominal ultrasound monitoring of adults presenting with chronic constipation and/or chronic nonspecific gastrointestinal (GI) complaints.

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

“…[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. 1,2,7,[9][10][11][12] Fecaloma was also associated with Chagas disease, Hirschsprung's disease, inflammatory and neoplastic diseases, scleroderma, diabetic neuropathy, and anorectal malformations. 2,4,7 The fecaloma's symptoms are various and non-specific.…”

“…1,2,7,[9][10][11][12] Fecaloma was also associated with Chagas disease, Hirschsprung's disease, inflammatory and neoplastic diseases, scleroderma, diabetic neuropathy, and anorectal malformations. 2,4,7 The fecaloma's symptoms are various and non-specific. The most common complaints are constipation, abdominal pain, abdominal distention, nausea and vomiting.…”

“…Fecaloma diagnosis is made radiologically through X-rays, barium enema, abdominal ultrasound, or abdominal CT scans. 1,2 Complications associated with fecal impaction are estimated at 40.6% of cases. 3 Some of these complications can be life threatening.…”

“…Fecaloma, a rare cause of fecal impaction, is an accumulation of hardened impacted stool typically occurring in the sigmoid colon and rectum and affecting, especially, elderly patients. [1][2][3][4][5] Symptoms of fecaloma are non-specific, dominated by constipation, abdominal pain, abdominal distention, nausea and vomiting. [3][4][5] The diagnosis is made through abdominal computed tomography scan (CT scan), X-rays or abdominal ultrasound.…”

“…[3][4][5] The diagnosis is made through abdominal computed tomography scan (CT scan), X-rays or abdominal ultrasound. 1,2 Fecaloma is often managed conservatively by manual disimpaction, laxatives and enemas. However, endoscopic or surgical interventions may be mandatory especially when it is refractory to conservative treatment or complicated.…”