Presentation
Severe generalized lower abdominal pain on a background of constipation following cystoscopy and TURBT six days prior.
Patient Data
Age: 85 years
Gender: Female
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- large volume of feces causing rectal distension with mild increased enhancement of the inferior rectal walls, associated perirectal fat stranding and small volume free fluid
- no evidence of extraluminal gas
- urinary bladder distension without evidence of perforation; small volume of gas within the bladder consistent with recent cystoscopy
- no intra-abdominal free gas or large volume free fluid
Case Discussion
CT of the abdomen/pelvis demonstrates findings consistent with stercoral proctocolitis, inflammation of the rectum secondary to fecal impaction (fecaloma). There is no imaging evidence to suggest the presence of stercoral perforation, a known complication of stercoral colitis. Significantly the CT also demonstrates no evidence of urinary bladder perforation, as although the patient did not present with overt clinical evidence of peritonism, this was an important consideration given the patient's recent history of cystoscopy with TURBT.
The patient's condition resolved with aperients.
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