Stercoral Colitis: A Surgical Dilemma

Abstract

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Diagnosis and emergency surgical management of stercoral colitis-induced colonic ischemia: A case report and literature review

“…Stercoral colitis occurs mostly in the sigmoid colon due to the narrowest part with less blood supply, and the hardest of feces [ 3 , 4 ]. The second most common location is the rectum or rectosigmoid junction, especially anteriorly, which is the anti-mesenteric section with a relatively low blood supply described as Sudeck's point [ 2 , 4 ] [ [7] , [8] , [9] ]. This condition is rare and need high index of suspicious [ 2 , 3 ] due to high morbidity and mortality when complicated by septic shock [ [7] , [8] , [9] ].…”

“…The second most common location is the rectum or rectosigmoid junction, especially anteriorly, which is the anti-mesenteric section with a relatively low blood supply described as Sudeck's point [ 2 , 4 ] [ [7] , [8] , [9] ]. This condition is rare and need high index of suspicious [ 2 , 3 ] due to high morbidity and mortality when complicated by septic shock [ [7] , [8] , [9] ]. Early diagnosis of bowel ischemia, especially from stercoral colitis, is challenging.…”

“…The incidence of stercoral colitis is extremely low [ 2 ]. Mortality from stercoral colitis-induced ischemia is high, and this rate depends on how early the diagnosis is made, by combined sign of intra-abdominal infection and laboratory tests such as CBC or serum lactate, and proper managements of sepsis resuscitation [ 1 , 2 ] [ [7] , [8] , [9] , [10] ].…”

“…Our literature search identified seven English language case reports of stercoral colitis-induce ischemia [ 3 , 4 ] [ [7] , [8] , [9] , [10] ] and show in Table.1 . The average age was 67.29-year-old (range: 26–87 year- old).…”

“…The common signs and symptoms suggestive of stercoral colitis are constipation with fecal impaction, abdominal pain and distension, and/or fever, which are the keys of stercoral colitis with or without ischemia. [ [1] , [2] , [3] , [4] ] [ [7] , [8] , [9] , [10] , [11] ]. Laboratory findings provide indirect evidence of ischemia as leukocytosis and blood lactate >4 mmol/l, which is an indicator of septic shock.…”