A faecaloma is a mass of faeces most frequently noted in the rectum and sigmoid colon, and is considered a severe/extreme form of faecal impaction.
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Clinical presentation
Symptoms are non-specific and include constipation, abdominal pain, anorexia, nausea, vomiting, overflow diarrhoea, faecal incontinence and urinary symptoms from pressure.
Pathology
Usually, the faecal matter accumulates in the intestine, then stagnates and increases in volume until the intestine becomes deformed and acquires characteristics similar to those of a tumour.
Aetiology
There are several causes of chronic constipation and faecaloma, for example:
- immobility (e.g. postoperatively, stroke, psychiatric illness)
- medication-related (e.g. opioids)
- neurological conditions (e.g. Parkinson disease, Hirschsprung disease)
- neoplastic conditions (e.g. colorectal cancer)
- inflammatory conditions (e.g. inflammatory bowel disease)
- infective conditions (e.g. Chagas disease)
- functional conditions (e.g. irritable bowel syndrome)
Radiographic features
CT
A faecaloma should be considered when there is evidence of focal faecal material of equal or greater diameter than the colon.