Abstract
Fecalomas are masses of hardened stool that are typically impacted in the sigmoid colon and rectum. Fecalomas are commonly associated with chronic constipation, Hirschsprung’s disease, Chagas disease, and multiple psychiatric conditions. We present a case of a giant fecaloma resulting in complete large bowel obstruction and suggest a five-year abdominal ultrasound monitoring of adults presenting with chronic constipation and/or chronic nonspecific gastrointestinal (GI) complaints.
Highlights
Fecaloma is an accumulation of hardened impacted stool typically located in the sigmoid colon and rectum [1,2,3]
We report a case of a giant fecaloma causing a complete large bowel obstruction requiring surgical management
Fecaloma is a result of the hardening of feces into lumps of many different sizes that are typically denser than fecal matter in cases of fecal impaction [6]
Summary
Fecaloma is an accumulation of hardened impacted stool typically located in the sigmoid colon and rectum [1,2,3]. In cases of large fecaloma, patients may feel a palpable hardened mass in their abdomen. We report a case of a giant fecaloma causing a complete large bowel obstruction requiring surgical management. A 46-year-old-female with a history of chronic constipation and abdominoplasty (10+ years ago) presented with a one-month history of worsening abdominal pain, nausea, and vomiting. An abdominal CT scan with intravenous (IV) contrast revealed a densely calcified rim of a fecaloma measuring 4.7 cm in diameter located in the mid sigmoid colon with wall thickening around the mass (Figure 1). The following day, the patient developed worsening abdominal pain. The ostomy was deemed a candidate for reversal four months after the exploratory laparotomy
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