![]() The opened specimen contained multiple fecalomas (compacted and hardened fecal matter) ( Figure 1.2, B). A colonic segment sent to pathology, 38 cm in length, revealed a 2.5 × 2-cm antimesenteric sigmoidal perforation ( Figure 1.2, A). Surgical exploration revealed feculent peritonitis, with a very large fecal impaction of the sigmoid-distended to 10 cm in diameter, with perforation of the sigmoid at the descending/sigmoid-colon junction. CT showed perforation of the colon with pneumoperitoneum. A 30-year-old man with a history of chronic constipation and polysubstance abuse (heroin, opioids, cocaine, and marijuana) was admitted for acute abdominal pain. Only a handful of stercoral colitis cases have been attributed to chronic heroin addiction. Cases occur in the settings of chronic constipation in the elderly, psychiatric disorders, and pharmacologic treatment with anticholinergic, opioid, or nonsteroidal anti-inflammatory drugs. The commonly reported site of ischemia and necrosis is the antimesenteric side of the sigmoid colon. Severe impaction leads to distention, increased pressure, and resultant necrosis and perforation of the intestinal wall. Stercoral colitis, from the Latin stercus (feces), refers to inflammation of a colon segment by fecal impaction.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |