Fecaloma with stercoral colitis
Severe abdominal pain.
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Large fecaloma in the rectum measuring 128mm in the AP dimension.
Associated mild rectal mural thickening suggestive of stercoral proctitis.
Fecaloma extends into distal sigmoid. No proximal large bowel obstruction.
This patient with a history of previous large stroke, bed bound and nonverbal, presented with non-specific pain which localized to the lower abdomen. CT showed large fecaloma with stercoral proctitis. She underwent manual disimpaction and enema with good effect. An uncommon but serious complication of fecaloma includes stercoral perforation and potential fecal peritonitis.