A fecaloma is a mass of feces most frequently noted in the rectum and sigmoid colon, and is considered a severe/extreme form of fecal impaction.
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Clinical presentation
Symptoms are non-specific and include constipation, abdominal pain, anorexia, nausea, vomiting, overflow diarrhea, fecal incontinence and urinary symptoms from pressure.
Pathology
Usually, the fecal matter accumulates in the intestine, then stagnates and increases in volume until the intestine becomes deformed and acquires characteristics similar to those of a tumor.
Etiology
There are several causes of chronic constipation and fecaloma, 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 fecaloma should be considered when there is evidence of focal fecal material of equal or greater diameter than the colon.
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