Massive fecal impaction

Case contributed by Dr Michael P Hartung

Presentation

Developmental delay with vomiting. Stool softeners stopped 1 month previously.

Patient Data

Age: 30 years
Gender: Male
CT

Presentation

Massive amount of stool filling the dilated and redundant sigmoid colon and rectum. The column of stool extends from the rectal vault through the upper abdomen and compresses the stomach and abdominal contents (10 x 13 x 35 cm, AP x TR X CC). No obstructing mass. No upstream obstruction of large or small bowel. 

X-ray

Next day

Radiograph obtained after multiple enemas, about 3.2 kg weight decrease. Substantial residual stool in the dilated distal colon. Increasing gaseous distention of upstream colon. 

Case Discussion

Young man with developmental delay and tremendous amount of impacted stool. Patient discontinued stool softener 1 month previously, but had been having normal bowel movements at the time of presentation according to the caregiver. Patient was managed conservatively with enemas. 

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Case information

rID: 61999
Published: 30th Jul 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Ascension Healthcare

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