A case of ileus caused by a fecalith in an elderly patient with severe dementia

Successful Resolution of Fecal Impaction During Endoscopy Using a Looped Guidewire

“…Complications of fecal impaction include ileus, ulceration, perforation, and obstructive colitis. [5][6][7][8][9]13 Obstructive colitis develops as a result of multiple factors, such as impaired mucosal blood flow due to increased intestinal pressure and abnormal intestinal flora, which are in turn caused by stagnation of intestinal contents. 6 Obstructive colitis is classified into the transient, stenotic, and necrotic types.…”

“…In the present case, the fecal mass persisted in spite of the administration of laxatives and enemas; therefore, more invasive treatment was required. There are several reports of surgical intervention for fecal impaction, [5][6][7][8][9] where the feces is manually identified and removed via an intestinal incision slightly proximal or distal to the mass. 9 Severe obstructive colitis or intestinal necrosis are indicative for bowel resection.…”

“…3 In mild cases, enema and osmotic laxatives, such as polyethylene glycol, are effective treatments; however, in severe or treatment-resistant cases, more invasive alternatives may be required. 1,[4][5][6][7][8][9] During surgery, it is difficult to determine how much of the bowel to resect, which is why this highly invasive procedure is often more extensive than necessary. 6 On the other hand, endoscopy is a less invasive technique that can be used to remove the feces; however, there is a limited amount of literature on its use for eliminating fecal impaction.…”