Presentation
Long history of constipation. Acute left lower quadrant pain. Raised inflammatory markers. tenderness on examination.
Patient Data
Large volume of solid fecal matter throughout colon. Wall thickening with surrounding fat stranding from the splenic flexure to the rectum. No free gas or collection. Small volume of free fluid in pelvis. No diverticulosis. Heavy vascular calcification. Appearances consistent with stercoral colitis, not complicated by perforation.
Case Discussion
The combination of the presenting complaint and the imaging features enables a diagnosis of stercoral colitis to be made. With ischemic colitis, the wall thickening would be lower in density and there would be some history of passage of bloody stools.
See these accompanying cases for examples of stercoral colitis complicated by perforation:
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