Stercoral perforation - ascending colon

Case contributed by Ammar Haouimi


3 days history of right abdominal pain. Long history of constipation.

Patient Data

Age: 55 years
Gender: Female

Focal perforation of the anterior wall of the ascending colon with adjacent extra-luminal free air extending to the perivesicular region (well-demonstrated on lung window) with moderate surrounding fat stranding. Solid fecal matter within the colon. No free peritoneal fluid or abscess formation. No colonic diverticulosis. Some reactive small bowel thickening in the pelvis.

Normal appearance of the appendix.

Case Discussion

CT features most consistent with stercoral perforation of the ascending colon with extraluminal free air, which was confirmed at surgery.

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