Imaging manifestations of faecal impaction and stercoral perforation

Stercoral colitis: diagnostic value of CT findings

“…Stercoral ulcers and perforated sites are often multiple as opposed to diverticulitis. Presence of fecal loading proximal to the stercoral perforation site and inflammatory involvement of the colon beyond the area of perforation, rather than only at the perforation site as in diverticulitis, may differentiate stercoral perforation from diverticular perforation (11).…”

Evaluating the Patient with Left Lower Quadrant Abdominal Pain

“…4). 69 Fecal impaction is differentiated from stercoral colitis by the lack of signs of ischemia or perforation. Fecal impaction may be complicated by obstruction, volvulus, or rectal prolapse.…”

“…Fecal impaction may be complicated by obstruction, volvulus, or rectal prolapse. 68,69 The distal colon and rectum should be evaluated to exclude a stricture or neoplasm as the cause of fecal impaction and obstruction. Water-soluble contrast enema may evaluate for stricture or neoplasm and can be used to attempt disimpaction, assuming there is no evidence of perforation or obstructing colon lesion.…”

“…The ischemia progresses to ulceration and perforation, often at multiple sites over a segment of involved bowel. 69 This finding is in contrast to diverticular perforations that are at a single site.…”

“…67,68 Paradoxic diarrhea with fecal incontinence is the most common complication, potentially leading to decubitus ulcers and urinary tract infection. 68,69 The term stercoral is synonymous with fecal. Stercoral colitis, necrotic stercoral colitis, stercoral ulcer, and stercoral perforation are terms used in the literature to describe the continuum of pressure-induced ischemia, erosion, and perforation of the bowel in the setting of fecal impaction.…”