, Volume 32, Issue 6, pp 417-418
Date: 15 Nov 2012

Rectal perforation by impacted fecaloma—a new mechanism proposed

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Editor:

A fecaloma is a mass of accumulated feces that is much harder in consistency than a fecal impaction. The rectosigmoid area is the common site for fecalomas [1]. Fecal impaction, defined as a “compacted, immovable mass of feces filling the rectum,” is commonly seen in chronic constipated patients. It can result in obstipation, the inability to pass stool or gas, but can also present with diarrhea, because liquid stool can pass around the impaction. If untreated, fecal impaction may result in a variety of complications, including stercoral perforation [2]. We describe a patient with stercoral perforation with an atypical location.

A 65-year-old female presented with nonpassage of flatus and stool for 8 days, abdominal distention for 5 days, vomiting and fever for 1 day, and a history of constipation for the last 5 years. On examination the pulse rate was 104/min and BP, 104/76 mmHg. The abdomen was distended, and generalized guarding was present. Per rectal examination revealed har ...