Stercoral colitis: Difference between revisions

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==Background==
==Background==
*Rare condition, inflammatory colitis related to increased intraluminal pressure from impacted fecal material in the colon
*Inflammatory [[colitis]] related to increased intraluminal pressure from [[fecal impaction|impacted fecal material]] in the colon
*Pressure may occur with ulceration resulting in perforation
**Pressure may cause ulceration and ultimately perforation
*Primarily in elderly, nursing home or young patients with neurological impairment
*Rare condition
*Primarily in elderly, nursing home or young patients with neurological impairment, chronic opioid use


==Clinical Features==
==Clinical Features==
 
*History of chronic [[constipation]]
*May be asymptomatic or have only mild [[abdominal pain]] at initial stages
*Abdominal pain/tenderness, distension, [[vomiting]] are most common symptoms <ref> Tsai TC, Chao CM. Stercoral colitis. Resuscitation & Intensive Care Med 2017;4:231-232 http://www.tsccm.org.tw/Magazine/Folder/a02_4/N20183712037_14-%BCv%B9%B3-10502-%BD%B2%A9v%A7%D3-231-232.pdf </ref>


==Differential Diagnosis==
==Differential Diagnosis==
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==Management==
==Management==
 
*Surgical consult
*May ultimately be treated nonsurgically (e.g. manual disimpaction, enemas) if no evidence of bowel perforation or ischemia


==Disposition==
==Disposition==
 
*Admit


==See Also==
==See Also==

Revision as of 17:27, 16 August 2019

Background

  • Inflammatory colitis related to increased intraluminal pressure from impacted fecal material in the colon
    • Pressure may cause ulceration and ultimately perforation
  • Rare condition
  • Primarily in elderly, nursing home or young patients with neurological impairment, chronic opioid use

Clinical Features

Differential Diagnosis

Constipation

Evaluation

  • CT findings with focal thickening of colonic wall, stranding of pericolonic fat in segment showing fecal impaction, and presence of extraluminal bubbles of gas or abscess [2]

Management

  • Surgical consult
  • May ultimately be treated nonsurgically (e.g. manual disimpaction, enemas) if no evidence of bowel perforation or ischemia

Disposition

  • Admit

See Also

External Links

References

  1. Tsai TC, Chao CM. Stercoral colitis. Resuscitation & Intensive Care Med 2017;4:231-232 http://www.tsccm.org.tw/Magazine/Folder/a02_4/N20183712037_14-%BCv%B9%B3-10502-%BD%B2%A9v%A7%D3-231-232.pdf
  2. Heffernan C. et al. Stercoral Colitis Leading to Fatal Peritonitis: CT findings. American Journal of Roentgenology, 2005. 184(4); 1189-1193.