Fecaloma with Megarectum: A Challenging Case of Giant Fecal Impaction

A BSTRACT Fecaloma is a rare condition characterized by a massive impaction of hardened fecal material within the colon, often associated with megarectum. Most cases respond to conservative management, but surgical intervention is occasionally required when conservative measures fail or complications arise. Presenting a case of 58-year-old female with chronic constipation and fecaloma in association with megarectum who had failed conservative management with laxatives, enemas, and manual evacuation despite 2 weeks of intensive treatment had underwent successful manual evacuation under spinal anesthesia. The patient recovered well with no postoperative complications and remained symptom-free at 6 months follow-up. This case highlights the importance of recognizing indications for intervention in fecaloma management and the favorable outcomes with timely intervention when conservative measures fail.