Stercoral colitis refers to a condition where the presence of impacted feces in the colonic lumen is associated with inflammation and distention of the affected colon segment.
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Epidemiology
It is seen primarily in elderly patients (often bedbound as a consequence of dementia, stroke, or orthopedic surgery). Less frequently, it may also be seen in younger patients who have metabolic, neurologic and/or muscular disorders causing constipation.
Clinical presentation
Symptoms are non-specific and include abdominal pain, abdominal distension, constipation, nausea and/or vomiting, and loss of appetite 6.
Pathology
Faecaloid formation is predominantly related to chronic constipation which leads to the development of a fecaloma (see article for possible underlying causes), which is a conglomeration of dehydrated fecal material. This causes distention of the colonic lumen and increases the pressure on the wall, which then decreases blood supply.
Radiographic features
CT
Typically shows a distended colon filled with feces and associated mural thickening. Other findings include fat stranding, mucosal sloughing, mesenteric hyperemia and extraluminal gas (if complicated by stercoral perforation).
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