Stercoral colitis: a rare cause of bowel ischaemia

Chew, Kenneth Keen Yip; Law, Cameron; Lee, Daniel

doi:10.1111/ans.16293

Cited by 3 publications

(9 citation statements)

References 8 publications

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“…Its pathogenesis was first postulated by Serpell and Nicholls in 1990, who reviewed 64 reported cases of stercoral perforation and observed that the disease involves an entire segment of colon rather than a single focal point of perforation. Furthermore, they recognized that fecal impaction was necessary to initiate the development of ischemic pressure necrosis [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…In SC, hard, dry fecal matter accumulates and becomes lodged within the hypomobile bowel [ 11 ]. This mass of dehydrated stool, termed a fecaloma or stercoroma, exerts pressure on the intestinal walls, resulting in marked colonic distension [ 3 , 7 , 9 , 10 ]. The vasculature within the surrounding bowel wall becomes compressed, leading to edema and inflammation.…”

Section: Discussionmentioning

confidence: 99%

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Stercoral colitis in the emergency department: a review of the literature

Bae,

Tran,

Shah

2024

Int J Emerg Med

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Background Stercoral colitis (SC) is a rare but potentially life-threatening inflammatory colitis caused by the accumulation of impacted fecal material. Despite reported associations with bowel perforation and high mortality rates, stercoral colitis remains a poorly defined and underrecognized diagnosis in the emergency department (ED). Objective of the review This review aims to summarize and synthesize existing literature on SC to guide its recognition and management in the ED. Discussion SC primarily occurs in elderly or bedbound patients with chronic constipation; however, it does occur in younger patients with comorbidities at increased risk for fecal impaction. Patients may present acutely with abdominal pain and distension, but clinical presentation is often nonspecific and varied, and there are no established diagnostic criteria for SC to date. CT is therefore crucial for diagnosis, revealing key findings such as fecaloma, colonic dilatation, and fat stranding. Treatment depends on severity of illness, ranging from manual disimpaction and other conservative measures for most cases, to surgical intervention for complicated cases, such as stercoral perforation. Conclusions SC can be a challenging diagnosis in the ED, often requiring multidisciplinary collaboration. Timely recognition and appropriate treatment are essential to reduce morbidity and mortality associated with this condition. Further research is needed to establish diagnostic criteria and clear management algorithms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stercoral colitis in the emergency department: a review of the literature

Bae,

Tran,

Shah

2024

Int J Emerg Med

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“…Stercoral colitis occurs mostly in the sigmoid colon due to the narrowest part with less blood supply, and the hardest of feces [ 3 , 4 ]. The second most common location is the rectum or rectosigmoid junction, especially anteriorly, which is the anti-mesenteric section with a relatively low blood supply described as Sudeck's point [ 2 , 4 ] [ [7] , [8] , [9] ]. This condition is rare and need high index of suspicious [ 2 , 3 ] due to high morbidity and mortality when complicated by septic shock [ [7] , [8] , [9] ].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and emergency surgical management of stercoral colitis-induced colonic ischemia: A case report and literature review

Wongwaisayawan,

Krutsri,

Koosaksathaporn

et al. 2023

International Journal of Surgery Case Reports

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“…Involvement of greater than 40 cms of the colon and intestinal perforation are the highest predictors of mortality 4 . A recent case report has described extensive ischemic colitis proximal to the site of fecal impaction from stercoral colitis 5 …”

Section: Discussionmentioning

confidence: 99%

“…4 A recent case report has described extensive ischemic colitis proximal to the site of fecal impaction from stercoral colitis. 5 Clinical presentation of stercoral colitis can vary from vague diffuse abdominal pain to acute abdomen with peritonism. It can be confused with diverticulitis, which is relatively more common in the elderly patients.…”

Section: Discussionmentioning

confidence: 99%