Stercoral colitis

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.