Report of an unusual case with severe fecal impaction responding to medication therapy

Abstract

Fecal impaction is a disorder characterized by a large mass of compacted feces in the rectum and/or colon, which cannot be evacuated. For mild and moderate fecal impaction, recommended treatments include stool softeners, oral mineral and olive oil, and edema; for severe fecal impaction, manual removal is needed and sometimes laparotomy may be indicated if medical therapies are not effective. Here we report a case with severe fecal impaction who did not defecate for 75 days. We treated this patient with vegetable oil, Chinese traditional medicine and enema in sequence. After 12 days of therapy, she evacuated hard fecal masses, and the symptoms were relieved.

Keywords: Fecal impaction; Intestinal obstruction; Therapy.

Figure 1

Abdominal radiograph. It shows a dilated colon with air-fluid level in the cecum, indicating the site of the intestinal obstruction.

Figure 2

Arterial phase of abdominal computed tomography (CT) scan. It shows the dilated ascending and transverse colon without colon wall thickening. The lumen of splenic flexure is filled with abundant fecal materials.

Figure 3

Follow-up abdominal radiographs after barium enema. Abundant barium remain in the 17th day (A), 24th day (B), and 33rd day (C). The fecal stasis is so obvious that it span from the cecum to the transverse colon, where it is well identified on the right of the abdomen.