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. 2017:40:39-42.
doi: 10.1016/j.ijscr.2017.09.002. Epub 2017 Sep 14.

Stercoral perforation of the rectosigmoid colon due to chronic constipation: A case report

Mustafa Fevzi Celayir  1 , Hakan Mustafa Köksal  2 , Mehmet Uludag  2
Affiliations

Stercoral perforation of the rectosigmoid colon due to chronic constipation: A case report

Mustafa Fevzi Celayir et al. Int J Surg Case Rep. 2017.

Abstract

Introduction: Chronic constipation is very common in elderly patients. As a result of this situation fecaloma is also frequently seen at these ages. However, the stercoral perforation caused by fecaloma is a rare situation to occur. The rectosigmoid colon is the most affected colonic segment. It is seen in older patients with concomitant diseases and a low quality of life.

Presentation of case: Here in this case, we have to report an 83 - year-old male patient who came to the emergency room with complaints of abdominal pain and constipation for two days. He had Type II Diabetes Mellitus, had a cardiac stent and also Alzheimer's disease. We diagnosed a rectosigmoid perforation due to a large fecaloma. This case presentation was prepared in accordance with the scare checklist guidelines (Agha et al., 2016 [1]).

Discussion: Constipation and faecal impaction are common entities, particularly in elderly and bedridden patients. Fecalomas are collections of dehydrated, hardened stool. They rarely can cause colonic ischemia and/or stercoral perforation. Stercoral perforation is the perforation or rupture of the intestine walls by a stercoraceous mass. Stercoral perforation is a very dangerous, life-threatening situation, as well as a surgical emergency, because the spillage of contaminated intestinal contents into the abdominal cavity leads to peritonitis, a rapid bacteremia with many complications.

Conclusion: Fecalomas can cause stercoral perforations. This situation can be confused with other causes of acuteabdomen in these patients. Early surgery can be life saving.

Keywords: Chronic constipation; Rectosigmoid; Stercoral perforation.

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Figures

Fig. 1
Fig. 1
Pneumoperitoneum at X-ray.
Fig. 2
Fig. 2
Fecaloma at abbominal CT.
Fig. 3
Fig. 3
Fecal contamination due to stercoral perforation at abdominal CT.
Fig. 4
Fig. 4
Perforation at the antimesenteric side of the distal sigmoid colon.
See this image and copyright information in PMC

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