Fecal Impaction in the Emergency Department

Corban, Caroline; Sommers, Thomas; Sengupta, Neil; Jones, Michael; Cheng, Vivian; Friedlander, Elizabeth; Bollom, Andrea; Lembo, Anthony

doi:10.1097/mcg.0000000000000458

Cited by 26 publications

(8 citation statements)

References 23 publications

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“…Fecal impaction refers to hard, large stool masses that are retained in the intestine [ 26 , 27 ]. Fecal impaction is diagnosed by abdominal palpation, rectal examination, and X-ray examination [ 27 , 28 ]. Abdominal palpation and rectal examination may be limited depending on the patient’s cooperation and previous laxative consumption [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

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The Appropriateness of Glycerin Enema in Pediatric Patients Visiting the Emergency Department

et al. 2021

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Objectives: We determined whether glycerin enemas were appropriately prescribed in pediatric fecal impaction patients using the Leech score and identified factors that influenced the prescription of glycerin enemas in the pediatric emergency department (PED). Methods: We included patients who received a glycerin enema at the PED of a tertiary teaching hospital. We divided the study subjects into two groups on the basis of their Leech scores: an appropriate enema group (Leech score ≥ 8), and an inappropriate enema group (Leech score < 8). Logistic regression was performed to determine the factors associated with glycerin enema administration. Results: The data of 998 patients, including 446 patients in the inappropriate enema group (Leech score 5.2 ± 1.7) and 552 patients in the appropriate enema group (Leech score 10.1 ± 1.7), were analyzed. A discharge diagnosis of fecal impaction was observed significantly more frequently (57.1%) in the appropriate enema group, and nonspecific abdominal pain (8.3%) and acute gastroenteritis (40.8%) were diagnosed significantly more frequently in the inappropriate enema group (p < 0.05). Constipation (2.8%) and irritability (3.0%) were slightly more common in the appropriate enema group than in the inappropriate enema group (p < 0.05). According to multiple logistic regression, subjects aged 2–8 years (2–4 years, OR 4.24; 4–8 years, OR 2.83), with vomiting (OR 1.72), with irritability (OR 4.52), and with a prolonged last defecation day (OR 1.2) were most likely to receive appropriate enema administration (p < 0.05). Conclusion: The results showed that in those aged 2–8 years, with vomiting and irritability, and with a prolonged last defecation day, an enema was generally administered appropriately.

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Section: Discussionmentioning

confidence: 99%

“…Enemas are a noninvasive, simple method of disimpaction and effective for immediate symptom relief [ 6 ]. However, pediatric patients dislike enemas due to discomfort [ 27 ], and enemas can cause various complications [ 7 , 8 , 9 , 10 ]. Therefore, enemas should be administered in only situations in which it is necessary.…”

Section: Discussionmentioning

confidence: 99%

The Appropriateness of Glycerin Enema in Pediatric Patients Visiting the Emergency Department

et al. 2021

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“…Fecal impaction is more common among older women who are in institutional care and have associated neuropsychiatric disorders. [6][7][8] Our patient was a 62-year-old female with chronic constipation and neurogenic bladder.…”

Section: Discussionmentioning

confidence: 99%

Massive fecal impaction with megarectum formation: A case report

Erdoğan¹

2019

South Clin Ist Euras

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Fecal impaction occurs because of hardened fecal matter retained in the colorectum which cannot be evacuated by peristaltic activity. Fecal impaction commonly occurs among nursing home residents, patients with neurological deficit, psychiatric disease or renal failure. Fecal impaction is usually treated by manual disimpaction, enemas and laxatives. Laparotomy is required only in the presence of complications. We herein report a case of a massive fecal impaction with megarectum in a 62-year-old woman who presented with large bowel obstruction. The aim of this report is to give a brief review of this entity and discuss the treatment options for these cases.

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“…Fecal impactions are commonly encountered in clinical practice and are a frequent cause for emergency department visits [2]. Chronic constipation, anatomic anorectal abnormalities (such as strictures, stenosis, Chagas disease, and Hirschsprung disease), and functional anorectal abnormalities (such as pelvic floor dysfunction, abnormal rectal sensation, and increased rectal compliance) increase the risk of fecal impaction [3].…”

Section: Discussionmentioning

confidence: 99%

Giant Fecalith Causing Near Intestinal Obstruction and Rectal Ischemia

Nigar

Sunkara

Culliford

et al. 2017

Case Rep Gastroenterol

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Fecal impaction if left untreated can lead to the hardening of stools and the formation of fecalith. Fecaliths rarely cause serious complications and are usually managed conservatively. We present this rare case of a giant fecalith causing near obstruction in an institutionalized paraplegic patient at high risk for chronic constipation and fecal impaction. This case was also unusual for causing ischemic pressure necrosis in the rectum, thereby highlighting the possible serious complications of fecalith.

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Fecal Impaction in the Emergency Department

Abstract: This study reports previously unexplored statistics on the number, frequency, and associated charges of ED visits with a primary diagnosis of fecal impaction, a condition found most commonly among elders.

Cited by 26 publications

References 23 publications

The Appropriateness of Glycerin Enema in Pediatric Patients Visiting the Emergency Department

The Appropriateness of Glycerin Enema in Pediatric Patients Visiting the Emergency Department

Massive fecal impaction with megarectum formation: A case report

Giant Fecalith Causing Near Intestinal Obstruction and Rectal Ischemia

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