Presentation
Constipation, abdominal pain, vomiting.
Patient Data
Large faecaloma measuring ~33 cm in length and up to 12.2 cm in width, dilating and obstructing the distal dolichosigma and rectum. The entire colon is full of gas and faeces and is massively dilated.
The kidneys are scarred. The right collecting system is moderately dilated and the left one is mildly dilated. The proximal ureters are mildly dilated down to where each is compressed between the dilated, faeces-filled rectum and the ipsilateral iliac vessels and psoas major muscle.
The uterus is deviated to the right and contains dense fluid - suspicious for uterine carcinoma.
Small left inguinal hernia, containing fat.
Lipoma between left serratus anterior and latissimus dorsi muscles.
Haemangioma in L5 vertebral body, small haemangioma in T10 body.
Anterolisthesis of L5 on S1, grade 1, due to degenerative facet joint hypertrophy.
Case Discussion
A patient with a history of constipation. Presented with abdominal distension, pain and vomiting, in addition to constipation. CT abdomen showed a huge faecaloma and a massively dilated colon and rectum. The Faecaloma was so wide that is exerted pressure on both ureters, with ensuing bilateral hydroureteronephrosis.
Treated with glove enema with evacuation of faecaliths and rectal tube enema with passage of a large amount of gas and faeces. Admitted for further treatment.
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