Abstract

Fecaloma is a mass of hardened faeces difficult to pass through the intestinal lumen. Due to various reasons, a bolus of fecal matter stagnates, accumulates and inspisates in the intestinal lumen, until it becomes big enough to cause intestinal obstruction. Though there are various predisposing factors for the formation of fecaloma but the actual cause of fecaloma formation is still unknown. Small gut fecalomas are very rare. Herein we are presenting a case of 50 year male who underwent laparotomy three times for small gut obstruction caused due to recurrent formation of small gut fecaloma. To our knowledge it is the first case report of recurrent small gut fecaloma obstruction to be reported.

Highlights

  • First described by Abella ME in 19671, fecaloma is a mass of hardened faeces difficult to pass through the intestinal lumen

  • Most of the impacted fecalomas have been reported in rectum and sigmoid[6,7].Up till only few cases of small gut fecaloma have been reported in the literature[8,9]

  • We have a case to report of a patient who got operated many times for recurrent small gut fecaloma obstruction

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Summary

BACKGROUND

First described by Abella ME in 19671, fecaloma is a mass of hardened faeces difficult to pass through the intestinal lumen. We have a case to report of a patient who got operated many times for recurrent small gut fecaloma obstruction. Khan MA et al, Recurrent Small Gut Fecalomas Causing Obstruction- A Case Report enterotomy with removal of fecaloma. This time intraoperatively there were multiple dense adhesions between gut loops with moderate amount of inter-loop fluid, hard fecaloma impacted at about 3 feet proximal to ileo-Caecal valve, gut proximal to fecaloma dilated and edematous wall. Because of history of recurrent small gut fecalomaobstruction and before taking down the ileostomy we tried to find out any systemic cause for the formation of recurrent fecalomas in this patient We did his thyroid profile, CFTR gene mutation (for adult onset cystic fibrosis) and CT enterography. After about 6 months of last operation, the ileostomy was taken down unevent-fully and patient was put on low fibre diet with laxatives and till patient is doing well

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CONCLUSION

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