Severe constipation causing ischaemic stercoral perforation of sigmoid colon

Abstract

Stercoral perforation is a rare but life-threatening condition that is increasingly being recognised as a sequelae of severe constipation. We present the case of a 45-year-old female who presented with stercoral perforation secondary to severe constipation related to adjuvant chemotherapy for colorectal cancer on a background of long-term antipsychotic medications. Chemotherapy-induced neutropaenia posed an additional treatment consideration in the management of sepsis associated with stercoral perforation. This case demonstrated that the morbidity and mortality from constipation especially in at risk patients cannot be underestimated.

Gastrointestinal: Stercoral colitis complicated with perforation and bleeding

“…1,2 Stercoral perforation is life-threatening and an early diagnosis and emergent surgery are necessary. 1,3 The incidence of colon perforation secondary to stercoral perforation is 3.2%, and the overall mortality is 34%. 2 In our case, the man with early stercoral perforation presented with hematochezia as his initial symptom.…”

“…The main symptoms are pain, fever, acute abdominal tenderness, and sepsis 1,2 . Stercoral perforation is life‐threatening and an early diagnosis and emergent surgery are necessary 1,3 . The incidence of colon perforation secondary to stercoral perforation is 3.2%, and the overall mortality is 34% 2 …”