Severe fecal impaction with stercoral colitis
Updates to Case Attributes
This is a case of a patient with a first presentation of constipation and obstructive symptoms with a large faecaloma and stercoral colitis. Although a rare complication of faecal impaction, pressure necrosis may lead to life-threatening faecal peritonitis. This patient was medically managed without further complications, and biopsy confirmation of Hirschprung's disease has not been obtained.
A 2008 study suggested that adult Hirschsprung's disease is more likely to appearmanifests as a markedly dilated proximal colonic segment with a transition zone and a narrowed distal colonic segment on CT.1
-<p> </p><p>This is a case of a patient with a first presentation of constipation and obstructive symptoms with a large faecaloma and stercoral colitis. Although a rare complication of faecal impaction, pressure necrosis may lead to life-threatening faecal peritonitis. This patient was medically managed without further complications.</p><p>A 2008 study suggested that adult Hirschsprung's disease is more likely to appear as a markedly dilated proximal colonic segment with a transition zone and a narrowed distal colonic segment on CT.<sup>1</sup></p>- +<p>This is a case of a patient with a first presentation of constipation and obstructive symptoms with a large faecaloma and stercoral colitis. Although a rare complication of faecal impaction, pressure necrosis may lead to life-threatening faecal peritonitis. This patient was medically managed without further complications, and biopsy confirmation of Hirschprung's disease has not been obtained.</p><p>A 2008 study suggested that adult Hirschsprung's disease manifests as a markedly dilated proximal colonic segment with a transition zone and a narrowed distal colonic segment on CT.<sup>1</sup></p>
References changed:
- Kim HJ, Kim AY, Lee CW, Yu CS, Kim JS, Kim PN, Lee MG, Ha HK. Hirschsprung disease and hypoganglionosis in adults: radiologic findings and differentiation. Radiology. 247 (2): 428-34. <a href="https://doi.org/10.1148/radiol.2472070182">doi:10.1148/radiol.2472070182</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/18430875">Pubmed</a> <span class="ref_v4"></span>
- 1. Kim HJ, Kim AY, Lee CW et-al. Hirschsprung disease and hypoganglionosis in adults: radiologic findings and differentiation. Radiology. 2008;247 (2): 428-34. doi:10.1148/radiol.2472070182
Updates to Study Attributes
Severe faecal impaction and stercoral colitis.
Large volume of faecal material is distending the rectum and sigmoid, with thickening of the wall of the rectum and loss of clear fat planes around the distended rectum. The maximal diameter of the rectum is 13 x 12cm, and it extends superior-inferior diameter of 23cm.
Considering the extent of involvement, consideration should be given to adult Hirschsprung's disease.
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