A stercoral perforation of the rectum due to a fecaloma is a rare disease with a high mortality rate. Although multiple case reports of colonic perforations have been published, the data regarding rectal perforations are limited. This case report will highlight one such case of a stercoral rectal perforation that was successfully treated with a laparoscopic operation.
Colon ; Constipation ; Fecal Impaction ; Rare Diseases ; Rectum

Humans ; Diverticulum, Colon ; Fecal Impaction ; Hydrodynamics

The perineal defect in female genitalia results from multiple etiologies, including obstetric injury, sexual assaults, and perineal trauma. Untreated defects may lead to significant physical, functional, and esthetic complaints. Numerous reconstruction methods are used for a perineal defect, but various complications, such as fecal impaction, fecal incontinence, and wound disruption, are introduced. We report a case of a 40-yr-old woman with a cloaca-like perineal defect, who was treated with reconstructive surgery of the perineal defect and recovered with a good anatomical and functional outcome.
Fecal Impaction ; Fecal Incontinence ; Female ; Genitalia, Female ; Humans

The treatment for constipation should be individualized and dependent on the cause, coexisting morbidities, and patient's cognitive status. Although most cases of constipation respond to conservative treatment, including dietary and life-style changes, or mild laxatives, some patients still complain of consistent symptoms and need an assessment of defecatory dysfunction. There is insufficient evidence to support the use of enemas in chronic constipation, although many clinicians and patients find them useful and effective for the treatment of fecal impaction when used with other modalities. In addition, suppositories can be considered as an initial trial for the treatment of defecatory dysfunction, since they help to initiate or facilitate rectal evacuation. The routine use of enemas is typically discouraged, especially sodium phosphate enemas, although tap-water enemas seem safe for more regular use. Soapsuds enemas are not recommended due to possible rectal mucosal damage.
Constipation* ; Enema* ; Fecal Impaction ; Humans ; Laxatives ; Sodium ; Suppositories*

PURPOSE: The aim of this study is to evaluate suitable tools for an approach to acute fecal impaction by comparison of the Leech, Barr and Blethyn scoring methods in pediatric emergency department (PED). METHODS: Children with diagnosis of fecal impaction were included in this study at PED of Seoul National University Hospital. Of them, 50 children were randomly selected and their radiographs were independently scored on two occasions at two weeks intervals using three scoring methods by nine emergency physicians and one radiologist. Inter-observer and intra-observer agreement were assessed by calculating intra-class correlation coefficient (ICC). Likert scale was used to assess the easiness and effectiveness of Leech, Barr and Blethyn scoring methods. RESULTS: (I) Inter-observer agreement: The ICC values of the Leech, Barr and Blethyn were 0.861, 0.887, and 0.821 at first trial and 0.889, 0.891, and 0.827 at second trial, respectively (p<0.001 for all). (II) Intra-observer agreement: Among researchers, the numbers who showed very confident (ICC>0.8) were 5, 6 and 2 in Leech, Barr and Blethyn, respectively. (III) Easiness and effectiveness: The mean Likert scale of the Leech, Barr and Blethyn in easiness was 4.4, 1.4, and 3.9 and in effectiveness, 3.9, 2.9, and 3.2, respectively; it showed significant differences for both attributes (p<0.001, p=0.03, respectively). In post-hoc test, the Leech was assumed to be easier and more effective than Barr (p<0.001). However, no significant differences in easiness and effectiveness were observed between Leech and Blethyn (p=0.37, p=0.14, respectively). CONCLUSION: The Leech, Barr and Blethyn have all good inter-observer agreement. The Leech has been found to carry better intra-observer agreement than the other two, and may be one of the easiest and most effective tools for the evaluation of acute fecal impaction in children in PED.
Child ; Emergencies ; Fecal Impaction ; Humans ; Observer Variation ; Radiography, Abdominal ; Research Design

Three cases of intestinal lipoma near the ileocecal valve are described. In patients of cecal and ileocecal valve lipoma, they had right lower quadrant abdominal pain secondary to partial intestinal obstruction. In rarely developed segmental lipomatosis of the ileum, the patient had right abdominal mass and pain to fecal impaction of the diverticula. Diagnosis may be made by an abnormal roentgenographic pattern and confirmed by colonoscopy. Surgical removal of the affected segment results in cure in symptomatic patients.
Abdominal Pain ; Colonoscopy ; Diagnosis ; Diverticulum ; Fecal Impaction ; Humans ; Ileocecal Valve ; Ileum ; Intestinal Obstruction ; Lipoma* ; Lipomatosis

Many hemodialysis patients, because of low fiber diet, water restriction, phosphate binder and endocrine-metabolic disturbance, suffer from chronic constipation. In a state of chronic constipation, a large amount of hard fecal mass often results in fecal impaction. Megacolon, urinary obstruction and perforation of the large bowel rarely develop as a complication of fecal impaction. The authors experienced a case of idiopathic sigmoid colonic perforation, with fecal impaction, in a 66-year-old woman having undergone hemodialyis of 6 years duration. The clinical features of the case are presented, with a review of the literatures.
Aged ; Colon, Sigmoid* ; Constipation ; Diet ; Fecal Impaction ; Feces ; Female ; Humans ; Intestinal Perforation ; Megacolon ; Renal Dialysis* ; Water

The stercoral colitis is an inflammatory process involving the colonic wall related to fecal impaction. This rare condition usually has a poor prognosis. We experienced a death case where an 84 years old woman died of stercoral colitis complications after total knee arthroplasty surgery. The fatal complications were peritonitis with systemic inflammatory response syndrome, not accompanying bowel perforations. We would like to show the autopsy case of stercoral colitis and suggest the importance of early suspicion and treatment.
Arthroplasty ; Autopsy ; Colitis ; Colon ; Fecal Impaction ; Female ; Humans ; Knee ; Peritonitis ; Prognosis ; Systemic Inflammatory Response Syndrome

Appendiceal intussusception is a rare condition of abdominal pain. It develops as a result of various anatomic or pathologic conditions, such as polyps, worms, carcinomas, mucoceles, or fecaliths. Furthermore, an accurate preoperative diagnosis of appendiceal intussusception may be difficult. However, recently developed radiologic modalities, such as multidetector CT and laparoscopy, can considerably aid preoperative diagnosis and provide a means of adopting optimal minimally invasive surgery. Here, the authors describe the case of a 30-yr-old woman with the clinical features of acute appendicitis, who was preoperatively diagnosed as having appendiceal intussusception with fecaliths and who was managed by using a laparoscopic partial cecectomy.
Abdominal Pain ; Appendicitis ; Fecal Impaction ; Female ; Humans ; Intussusception ; Laparoscopy ; Mucocele ; Polyps

Stercoral ulcer is the ulcerated colonic mucosa due to the pressure effects of hard, scybalous feces. It is a rare clinical entity that usually occurs in the elderly, or the bedridden patients with chronic constipation, and usually located in the rectosigmoid area. If stercoral ulcer is presented with fatal complications such as massive hemorrhage or perforation, emergent operation is needed. There has been very few reports of stercoral ulcer found in the proximal colon. We experienced an unusual case of stercoral ulcer in the proximal colon in a middle-aged woman who had not suffered any organic disease, and she recovered completely after medical conservative treatment only, so we report this case with a review of the literature.
Aged ; Colon* ; Constipation ; Fecal Impaction ; Feces ; Female ; Hemorrhage ; Humans ; Mucous Membrane ; Ulcer*