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Case Reports
. 2020 Jul 11;12(7):e9146.
doi: 10.7759/cureus.9146.

Pelvic Rectal Stercoral Perforation Resulting in Diffuse Pneumatosis

Anupam K Gupta  1 , Oscar A Vazquez  2 , Miguel Lopez-Viego  2   3
Affiliations
Case Reports

Pelvic Rectal Stercoral Perforation Resulting in Diffuse Pneumatosis

Anupam K Gupta et al. Cureus. .

Abstract

An 83-year-old woman with oral corticosteroid use for chronic autoimmune conditions presented with abdominal pain and constipation for the previous seven days. CT of the abdomen and pelvis revealed a large fecaloma with diffuse pneumatosis involving the retroperitoneum, subcutaneous tissue, and mediastinum. An emergent exploratory laparotomy revealed perforation of the rectum below the peritoneal reflection into the retroperitoneum. An end-colostomy with Hartmann's operation was then performed intra-operatively. Despite operative treatment complicated by prolonged intubation, the patient succumbed to multiorgan failure and expired.

Keywords: fecaloma; pneumatosis; stercoral perforation; surgery.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Fecaloma in rectum (solid arrow). Pneumoperitoneum with air in the pelvis (outlined arrow)
Figure 2
Figure 2. Pneumomediastinum (outlined arrow) with air in the retroperitoneum (solid arrow)
Figure 3
Figure 3. Air in the abdominal cavity, retroperitoneum, and subcutaneous tissue (solid arrow)
See this image and copyright information in PMC

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