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*

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

Colonoscopy is a relatively safe procedure with few complications. However, it may be accompanied with complications such as bleeding, perforation and, rarely, acute appendicitis. Acute appendicitis occurs when the appendiceal opening is obstructed by lymphoid hyperplasia, fecalith or foreign materials. In case of late detection, acute appendicitis can results in perforation and panperitonitis. Therefore early diagnosis and proper management is mandoctory. We experienced a 70-year-old female patient who visited for abdominal pain and tenderness after the diagnostic colonoscopy and was found to develop acute appendicitis. Herein, we report the case with the review of literatures.
Abdominal Pain ; Aged ; Appendicitis* ; Colonoscopy* ; Early Diagnosis ; Fecal Impaction ; Female ; Hemorrhage ; Humans ; Hyperplasia

PURPOSE: Constipation in children usually is due to poor bowel habit. Ignoring the urge to have a bowel movements initiates a viscious cycle of constipation. After a period of time children may stop feeling the urge, leading to fecal impaction. This leads to loss of anorectal reflex. What is the outcome of the children with long-standing poor bowel habit? METHODS: Forty-two patients with obstructed defecation (non-relaxing puborectalis syndrome) diagnosed by defecogram and anorectal manometry were investigated with rectal sensation and elasticity studies (threshold of sense: TS, defecation sensation volume: DS, maximal tolerable volume: MTV, rectal compliance: RC), and colon transit time (CTT). All detailed questionnaires on the subject were completed. Eighteen patients (11F: 7M, mean age 39 years, range 16~75) with history of poor bowel habits since childhood were compared with 24 (16F: 8M, mean age 40 years, range 16~31) with no history of poor bowel habit. RESULTS: Studies of colonic transit time demonstrated no significant difference in the right and left colon between two groups, but the rectosigmoid transit time in the poor bowel habits group was more increased than in the normal bowel habit group (P<0.05). The rectal wall compliance was increased in the poor bowel habit group as compared to the normal bowel habits group (P<0.01). Maximal tolerable volume and defecation sensation volume were greater in the poor bowel habits group than in the control group (P<0.01), but there was no significant difference in the threshold of sense between two groups. CONCLUSIONS: Prolonged poor bowel habit in childhood period leads to loss of rectal sensation, and provide an explanation for one of the pathophysiologic mechanism of non-relaxing puborectalis syndrome.
Child ; Colon ; Compliance ; Constipation ; Defecation ; Elasticity ; Fecal Impaction ; Humans ; Manometry ; Surveys and Questionnaires ; Reflex ; Sensation

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