Faecaloma/impacted faecal matter

Case contributed by Dr Ali Abougazia

Presentation

Three months of constipation. Sense of lower abdominal/rectal fullness with passage of small amounts of hard stool.

Patient Data

Age: 52
Modality: Barium

The rectum and distal sigmoid colon are distended by the injected Barium with a proximal sigmoid colon (mostly intraluminal) mass with a rounded edge obstructing the flow of Barium to descending colon. The mass wasn't dislodged by changing the patient's decubitus or after rotating the patient.

Complimentary CT

Modality: CT

The sigmoid mass observed on the Barium study is seen in the CT study to be an intraluminal globular mass with a finely corregated surface and internal low density (fat) foci. The proximal bowel is collapsed with no evidence of intestinal obstruction.

Follow-up Barium study after 1 week of laxatives.

Modality: Barium

The previously seen intraluminal sigmoid mass is still seen in today's study with the barium reaching the proximal sigmoid colon, confirming the non-obstructing nature of the lesion.

Case Discussion

Taking into consideration the patient's complaint of prolonged constipation and absence of psychiatric illness, this mass is mostly a faecaloma/impacted faecal matter causing constipation.

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Case Information

rID: 31768
Case created: 27th Oct 2014
Last edited: 5th Oct 2015
Inclusion in quiz mode: Included

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