Stercoral Ulcer Not Always Indolent: A Rare Complication of Fecal Impaction

Stercoral sigmoid perforation is a dangerous surgical emergency. It is also a life-threatening situation because the spillage of fecal contents into the abdominal cavity leads to sepsis with many postoperative complications. Chronic, intermittent constipation can lead to fecal impaction, especially...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2018-05, Vol.10 (5), p.e2613
Main Authors: Vijayakumar, Chellappa, Balagurunathan, K, Prabhu, Ravi, Santosh Raja, Erabati, Amankumar, Singh, Kalaiarasi, Raja, T, Swetha
Format: Article
Language:English
Subjects:
Abdomen
Case reports
Colon
Gastroenterology
General Surgery
Mortality
Sepsis
X-rays
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Summary:Stercoral sigmoid perforation is a dangerous surgical emergency. It is also a life-threatening situation because the spillage of fecal contents into the abdominal cavity leads to sepsis with many postoperative complications. Chronic, intermittent constipation can lead to fecal impaction, especially in older patients. An 80-year-old male patient presented with intestinal abdominal pain and distention for three days. His chest X-ray showed air under the diaphragm. On laparotomy, a small rent was discovered in the rectosigmoid junction with fecal contamination. The presence of a fecaloma is the speculated reason for the perforation. Primary closure of the defect with a diverting transverse colostomy was performed, and subsequently, the patient recovered well. A colostomy closure was performed six weeks after the primary surgery. It is imperative to understand the incidence of stercoral perforation in a normal bowel. Early treatment and intervention are the important aspects of stercoral pathology. We report a rare case of stercoral sigmoid colonic perforation with fecal peritonitis.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.2613