Key result
Large fecaloma causes life-threatening rectosigmoid stercoral perforation in an elderly patient with chronic constipation.
Why the study?
Stercoral perforation caused by fecaloma is a rare but life-threatening complication of chronic constipation, especially in elderly patients with comorbidities.
Case Report (n=1)
Fecalomas can cause life-threatening stercoral perforations in elderly patients with chronic constipation, which can be confused with other causes of acute abdomen and require early surgery.
Alerts clinicians to stercoral perforation in constipated elderly patients with acute abdomen; leaves open optimal management strategies for this rare entity.
INTRODUCTION: Chronic constipation is very common in elderly patients. As a result of this situation fecaloma is also frequently seen at these ages. However, the stercoral perforation caused by fecaloma is a rare situation to occur. The rectosigmoid colon is the most affected colonic segment. It is seen in older patients with concomitant diseases and a low quality of life. PRESENTATION OF CASE: Here in this case, we have to report an 83 - year-old male patient who came to the emergency room with complaints of abdominal pain and constipation for two days. He had Type II Diabetes Mellitus, had a cardiac stent and also Alzheimer's disease. We diagnosed a rectosigmoid perforation due to a large fecaloma. This case presentation was prepared in accordance with the scare checklist guidelines (Agha et al., 2016 [1]). DISCUSSION: Constipation and faecal impaction are common entities, particularly in elderly and bedridden patients. Fecalomas are collections of dehydrated, hardened stool. They rarely can cause colonic ischemia and/or stercoral perforation. Stercoral perforation is the perforation or rupture of the intestine walls by a stercoraceous mass. Stercoral perforation is a very dangerous, life-threatening situation, as well as a surgical emergency, because the spillage of contaminated intestinal contents into the abdominal cavity leads to peritonitis, a rapid bacteremia with many complications. CONCLUSION: Fecalomas can cause stercoral perforations. This situation can be confused with other causes of acuteabdomen in these patients. Early surgery can be life saving.
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Celayir et al. (2017) conducted a case report in Stercoral perforation of the rectosigmoid colon (n=1). Fecaloma was evaluated on Rectosigmoid perforation. A large fecaloma caused a life-threatening stercoral perforation of the rectosigmoid colon in an 83-year-old male patient with chronic constipation.
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