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Review
. 2025 Feb 4;19(1):48.
doi: 10.1186/s13256-025-05039-y.

Fecaloma causing small bowel obstruction in the absence of risk factors: a case report

Youssef Ahmad  1 , Umer Siddiqui  2 , Ayman Ahmed  2 , Aiswarya Sudheer  3 , Tejaswi Chetla  4 , Inayat Shergill  5 , Fadi Souleiman  6
Affiliations
Review

Fecaloma causing small bowel obstruction in the absence of risk factors: a case report

Youssef Ahmad et al. J Med Case Rep. .

Abstract

Background: Small bowel obstruction is a common surgical emergency typically caused by adhesions, hernias, and malignancies. However, ileal fecalomas represent an exceptionally rare etiology, with few cases reported in literature. This case study and literature review aim to highlight an unusual cause of small bowel obstruction, emphasizing the diagnostic challenges and management strategies.

Case presentation: A 60-year-old Middle Eastern female patient from Syria with a 1-year history of chronic constipation presented with abdominal pain, vomiting, and an inability to pass feces. Diagnostic imaging confirmed small bowel obstruction, which was caused by a fecal mass proximal to the ileocecal junction. Surgical extraction successfully resolved the obstruction.

Conclusion: This case underscores the importance of considering fecal impaction as a differential diagnosis in patients with chronic constipation and highlights the effectiveness of surgical intervention in resolving such obstructions. A comprehensive review of literature on unusual causes of small bowel obstruction, including imaging characteristics and management approaches, is also provided to enhance clinical awareness and improve patient outcomes.

Keywords: Abdominal mass; Case report; Constipation; Hardened feces mass; Ileocecal junction; Laparoscopic surgery; Small bowel obstruction; Surgical intervention.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors have no relevant financial interests and no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
a Narrowing transitional zone of the jejunal loops above the left iliac fossa, b severe luminal narrowing of the intestinal loop with localized posterior wall thickening and proximal intestinal dilation
Fig. 2
Fig. 2
a Fecal mass causing obstruction proximal to the ileocecal junction, b the fecal mass after surgical extraction
See this image and copyright information in PMC

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