Skip to main content

Table 1 Comparison of our patient with published data on stercoral colitis

From: Stercoral colitis complicated with ischemic colitis: a double-edge sword

Case # Patient Past Medical History Presentation Physical Examination Findings Laboratory Findings Imaging Findings Course of Stay
1 (our case) 87-year-old male HTN, Hypercholesterolemia, benign colon polyps, & chronic constipation Severe diffuse abdominal pain with distension and bloating sensation of 5 days duration Abdominal exam: moderate diffuse tenderness but no rigidity or guarding;
Rectal exam: impacted stool
Leukocytosis and lactic acidosis AXR: large amount of gas and fecal retention throughout the colon and rectum with no evidence of free intraperitoneal air; Contrast-enhanced CT abdomen/pelvis: large number of retained stools in the colon, bowel wall thickening and infiltration of peri-colonic fat Findings suggestive of stercoral colitis complicated with ischemic colitis treated with I.V. fluids and antibiotics; Enema, followed by laxative and manual disimpaction of stools; symptoms were resolved and lactate levels returned to normal; patient became stable and discharged home
2 (12) 35-year-old male Schizoaffective disorder Diffuse cramping abdominal pain and constipation of 4 days duration Abdominal exam: marked distention, diffuse tenderness to palpation, and stool palpable in the left lower quadrant with normal bowel sounds;
Rectal exam: refused
Normal Contrast-enhanced CT abdomen/pelvis: stool impaction with colonic wall thickening, but no small bowel obstruction, obstructing mass, or volvulus Despite I.V. fluids and laxatives course was complicated with lactic acidosis and perforation of transverse colon with mucosal ulceration and focal ischemia. Patient underwent sub-total colectomy and was discharged with an ileostomy
3 (12) 26-year-old male Long history of anxiety around using the restroom, after experiencing an earthquake while using the toilet at age 6 Constipation of 1 week; cramping abdominal pain in the lower quadrants and shortness of breath Abdominal exam: distended and nontender, with stool palpable in the left lower quadrant and normal bowel sounds throughout;
Rectal exam: hard stool palpated in the rectal vault
Normal AXR: dilated colon with severe fecal impaction, without pneumoperitoneum; Contrast-enhanced CT abdomen/pelvis: fecal impaction with signs of bowel ischemia, but no free air or ascites were identified Patient was treated with I.V. fluids, oral laxatives, and water enemas. Discharged home in stable condition
4 (13) limited data 76-year-old male DM, HTN, arrhythmia, chronic constipation Acute abdomen; febrile N/A Leukocytosis CT abdomen/pelvis: fecal impaction at recto-sigmoid colon; colon mucosal perfusion defect; pericolonic stranding;
Operation findings/Pathology: Ischemic change from sigmoid to rectum with necrotic mucosa/Ischemia necrosis with
mucosal sloughing
Alive; limited information
5 (13) limited data 39-year-old male ESRD, chronic constipation Acute abdomen; hypotensive and febrile N/A Borderline leukocytosis CT abdomen/pelvis: fecal impaction at recto-sigmoid colon with proximal dilatation; pericolonic stranding;
Operation findings/Pathology: Ischemic patches over sigmoid colon with impending perforation/Ischemic and gangrenous
change of the sigmoid colon
Dead, 3 days after CT; limited information
6 (13) Limited data 83-year-old male ARDS, HF, HTN, COPD, chronic constipation Acute abdomen N/A Leukocytosis CT abdomen/pelvis: fecal impaction at recto-sigmoid colon; colon wall thickening; colon mucosal perfusion defect; pericolonic stranding;
Operation findings/Pathology: Ischemic change of small bowel and sigmoid colon/Transmural necrosis of sigmoid colon and mucosal necrosis of small bowel
Dead, 11 days after CT; limited information
  1. HTN Hypertension, AXR Abdominal X-ray, DM Diabetes mellitus, N/A Not available, ESRD End-stage renal disease, ARDS Acute respiratory distress syndrome, HF Heart failure, COPD Chronic obstructive pulmonary disease