Stercoral colitis: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
[[File:179e455f29abdcd110a7e67428587e big gallery.jpg|thumb|Abdominal CT showing stercoral colitis with preformation (free air shown by arrows).]] | |||
*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 <ref> Heffernan C. et al. Stercoral Colitis Leading to Fatal Peritonitis: CT findings. American Journal of Roentgenology, 2005. 184(4); 1189-1193. </ref> | *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 <ref> Heffernan C. et al. Stercoral Colitis Leading to Fatal Peritonitis: CT findings. American Journal of Roentgenology, 2005. 184(4); 1189-1193. </ref> | ||
Revision as of 16:08, 2 August 2023
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
- 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 [1]
- Mortality rate between 32-59% if associated with perforation[2]
Differential Diagnosis
Constipation
- Behavioral-related
- Lack of exercise
- Diet-related
- Fecal impaction
- Ileus from surgical abdomen
- Bowel obstruction
- Small bowel obstruction
- Large bowel obstruction
- Malignant bowel obstruction
- Specific causes: tumor, stricture, hernia, adhesion, volvulus
- Painful anorectal disorders (e.g. anal fissure, hemorrhoids)
- Medical causes
- Hypothyroidism
- Electrolytes
- Hypokalemia
- Medication-related
- Opiods, antipsychotics, anticholinergics, antacid, antihistamines
- Constipation (peds)
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 [3]
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
- ↑ 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
- ↑ Morano C, Sharman T. Stercoral Colitis. [Updated 2022 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560608/
- ↑ Heffernan C. et al. Stercoral Colitis Leading to Fatal Peritonitis: CT findings. American Journal of Roentgenology, 2005. 184(4); 1189-1193.