Presentation
Increasing abdominal distension with background history of chronic constipation.
Patient Data
Gross dilatation of air-filled small bowel loops ( decided by central location and presence of valvulae conniventes), measuring up to 5.0cm in diameter.
The large bowel loops (cecum, ascending colon, transverse colon, descending colon and proximal sigmoid colon) are grossly dilated with mural wall thickening. Largest diameter is at the distal transverse colon measures 13.0cm. Large volume of solid fecal material within these dilated large bowel loops.
Case Discussion
Chronic constipation is a major risk factor for stercoral collitis which can cause fecal impaction. CT scan is the most useful imaging modality for the diagnosis of stercoral colitis. CT imaging features that should prompt the radiologist to consider this diagnosis include
colonic dilatation containing impacted feces
mural thickening
pericolic fat stranding.
Life-threatening complications such as colonic perforation can occur if the fecal impaction is not timely relieved.
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