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*

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*

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

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

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

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

An inverted appendix is a rare condition that develops in conjunction with pathologic or anatomic conditions, such as polyps, worms, carcinomas, mucoceles, fecaliths, or post-appendectomy. There are few reports of congenital inverted appendices. The clinical symptoms can range from no symptoms to acute or chronic lower abdominal pain, as in appendicitis. An inverted appendix can be diagnosed by barium enema, colonoscopy, ultrasound, and CT scan, but few cases are reported pre-operatively. Indeed, most cases are diagnosed intra-operatively. Because an inverted appendix is often misdiagnosed as a polyp during colonoscopy, it is important to differentiate an inverted appendix from a polyp or tumor for therapeutic planning. We report herein a 76-year-old woman who had no clinical symptoms of a congenital inverted appendix which had been observed without any treatment or symptoms over a 7 year period.
Abdominal Pain ; Aged ; Appendicitis ; Appendix ; Barium ; Colonoscopy ; Enema ; Fecal Impaction ; Female ; Humans ; Intussusception ; Mucocele ; Polyenes ; Polyps