Fecaloma causing megacolon and bilateral hydronephrosis

Tu, Kuan-Chi; Kuo, Jinn‐Rung

doi:10.4103/fjs.fjs_58_19

Cited by 3 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11) Bedridden patients with immobility owing to neurological or traumatic sequelae are at a higher risk of developing urinary tract obstruction caused by chronic constipation-induced fecalomas, especially if they are superimposed by insufficient fluid intake, dehydration, or administration of drugs that decrease GI tract motility. [12][13][14] Moreover, patients with schizoaffective disorders who are receiving antipsychotic, anticholinergic, tricyclic antidepressant, and antiserotonergic medication are also at a higher risk. [12][13][14][15] Consistent with these reports, our patient was also bedridden owing to a previous cerebral infarction and femur fracture; she also had a history of chronic constipation.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] Moreover, patients with schizoaffective disorders who are receiving antipsychotic, anticholinergic, tricyclic antidepressant, and antiserotonergic medication are also at a higher risk. [12][13][14][15] Consistent with these reports, our patient was also bedridden owing to a previous cerebral infarction and femur fracture; she also had a history of chronic constipation. Moreover, her medical records confirmed that the patient had been taking analgesics for the femur fracture.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Hydronephrosis owing to A Giant Fecaloma in an Older Patient

Joo

Lee

2020

Ann Geriatr Med Res

View full text Add to dashboard Cite

Acute urinary tract obstruction can cause acute kidney damage and urinary tract infections, which can lead to potentially fatal complications. Although rare, acute urinary tract obstruction can be caused by compression of the gastrointestinal (GI) tract. Some cases of acute urinary tract obstruction by giant fecalomas caused by chronic constipation have been reported in patients with immobility and dehydration. 1) In addition, constipation and fecal impaction are common clinical problems in older adults. 2) Even with its clinical relevance, chronic constipation is rarely suspected as a predisposing cause of urinary tract obstruction. To date, there have been no reports of fecaloma-related acute hydronephrosis owing to chronic constipation in Korea. Here, we report a case of acute hydronephrosis owing to a giant fecaloma in an older patient. CASE REPORT An 83-year-old woman with a fever presented to the emergency room. She had a 10-year history of chronic constipation and was in a Hydroureteronephrosis with acute urinary tract obstruction can lead to serious complications such as obstructive nephropathy or pyelonephritis. We report the first case of hydroureteronephrosis caused by a giant fecaloma in an 83-year-old woman accompanied with chronic constipation in Korea. The patient with a fever presented to the emergency room and was diagnosed with right hydronephrosis. Computed tomography revealed a markedly dilated rectum with a giant fecaloma compressing the right vesicoureteric junction. Hydroureteronephrosis was resolved through manual disimpaction of the fecaloma and simultaneous lavage with rectal tubes, which improved the acute pyelonephritis and renal function. Chronic constipation can lead to giant fecaloma threatening urinary tract patency, especially in older patients with immobility or dehydration. Therefore, clinicians should consider this condition as a rare but possible cause of hydronephrosis in older patients with chronic constipation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute Hydronephrosis owing to A Giant Fecaloma in an Older Patient

Joo

Lee

2020

Ann Geriatr Med Res

View full text Add to dashboard Cite

show abstract

“…[3][4][5] Chronic constipation, frequently seen in elderly and bedridden patients, plays an important role in the development of fecaloma 1,3,4,8 Other common risk factors reported in the literature were neuropsychiatric diseases and use of constipating medication like antiepileptic, antidepressant and opioid therapy. 1,2,7,[9][10][11][12] Fecaloma was also associated with Chagas disease, Hirschsprung's disease, inflammatory and neoplastic diseases, scleroderma, diabetic neuropathy, and anorectal malformations. 2,4,7 The fecaloma's symptoms are various and non-specific.…”

Section: Discussionmentioning

confidence: 99%

“…3 Some of these complications can be life threatening. 7,14 Colonic complications, secondary to the effect of the fecaloma on the intestinal wall or lumen, leads to several injuries like bowel obstruction, 2,15 Intussusception, 16 stercoral ulcer, 1,11 stercoral colitis 8 or toxic megacolon leading to colonic perforation and fecal peritonitis and bleeding 2,3,7 Otherwise, the fecal mass can compress adjacent anatomical structures and lead to hydronephrosis, 12,14,17 nerve compression and deep vein thrombosis. The fecaloma's management is sometimes challenging.…”

Section: Discussionmentioning

confidence: 99%

“…The conservative treatment of fecalomas, especially those located in the rectum, consists of manual disimpaction of the fecal mass associated with the administration of laxatives and enemas to soften the hardened stool. [12][13][14] Oral lavage with polyethylene glycol solution in sometimes helpful in case of proximal fecal impaction. 4 Successful management of fecaloma by an endoscopic fragmentation of fecal material in the distal colon has been recently reported.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Case Report: A giant fecaloma revealed by severe aspiration pneumonia and urinary retention

et al. 2021

View full text Add to dashboard Cite

Fecaloma is an accumulation of hardened impacted stool typically occurring in the sigmoid colon and rectum. It mainly affects elderly and bedridden patients suffering from chronic constipation and can be revealed by different signs. We report a case of 74-year-old female, with anorexia, Alzheimer’s disease, and chronic constipation, who was admitted to the emergency department with complaints of dyspnea and anuria. Clinical examination showed fever, Glasgow Coma Scale score of 13/15, tachycardia with a blood pressure of 100/50 mmHg, polypnea with hypoxia, foci of crepitant rales in pulmonary auscultation and a tender hypogastric mass with mild diffuse abdominal tenderness. Digital rectal examination revealed hard fecal material. Computed tomography (CT) images demonstrated bilateral pulmonary parenchymal condensation and a huge heterogeneous fecaloma in the sigmoid colon and rectum compressing the bladder. Based on these findings, the diagnosis of giant fecaloma causing aspiration pneumonia and urinary retention was retained. Manual disimpaction and bowel enemas were done but they were unsuccessful and surgical treatment was refused. Ultimately the patient died due to septic shock. Early diagnosis should be made to relieve symptoms and prevent complications.

show abstract

Overflow diarrhea and acute kidney injury as a presentation of fecal impaction that led to obstructive uropathy

Dave¹

2021

MOJCR

View full text Add to dashboard Cite

Fecal impaction is a known complication of chronic constipation and is particularly bothersome in the elderly population. Common complications of fecal impaction include hemorrhoids, megacolon, overflow diarrhea, and obstructive uropathy among others. Many case reports have been reported with fecal impaction and obstructive uropathy though none have reported overflow diarrhea as a presentation. In this case report, we present an elderly male who came in with overflow diarrhea and acute kidney injury that resulted from fecal impaction that caused obstructive uropathy. He was managed with catharsis and early recognition of the condition led to a good outcome. Recognition and management of fecal impaction can be challenging especially in patients who present with diarrhea. We, therefore, outline and discuss the importance of recognition of overflow diarrhea as a complication of fecal impaction and the management of such patients.

show abstract

Fecaloma causing megacolon and bilateral hydronephrosis

Cited by 3 publications

References 10 publications

Acute Hydronephrosis owing to A Giant Fecaloma in an Older Patient

Acute Hydronephrosis owing to A Giant Fecaloma in an Older Patient

Case Report: A giant fecaloma revealed by severe aspiration pneumonia and urinary retention

Overflow diarrhea and acute kidney injury as a presentation of fecal impaction that led to obstructive uropathy

Contact Info

Product

Resources

About