Stercoral Colitis: When Constipation is an Emergency

Panneerselvam, Sugi; Carlson, Jeffrey J.; Lin, Doris

doi:10.1016/j.amjms.2020.11.013

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…SC most commonly affects elderly patients with chronic constipation, particularly those who are bedridden, residing in a nursing home, or with neurocognitive impairment, as they are at increased risk for fecal impaction [ 2 , 7 , 20 ]. The mean age of onset is thought to be over 60 [ 21 ]; however, cases have been described in younger patients with chronic opioid use, psychiatric conditions, and comorbidities predisposing to prolonged constipation such as hypothyroidism, diabetes, and renal failure [ 12 , 20 , 22 ]. Rare cases are seen in pediatric patients with a history of constipation [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Strikingly, this study revealed that abdominal pain was documented as absent in over 60% of patients, and over 25% of patients lacked abdominal tenderness on physical examination [ 5 ]. While most case reports describe patients with abdominal pain and tenderness, few have similarly reported cases where the abdominal examination was initially benign in the ED [ 22 ]. Fever, leukocytosis, and elevated acute phase reactants have also been associated with SC, though Keim’s group noted that the majority of patients in their cohort lacked any of those findings [ 5 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

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Stercoral colitis in the emergency department: a review of the literature

Bae,

Tran,

Shah

2024

Int J Emerg Med

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Background Stercoral colitis (SC) is a rare but potentially life-threatening inflammatory colitis caused by the accumulation of impacted fecal material. Despite reported associations with bowel perforation and high mortality rates, stercoral colitis remains a poorly defined and underrecognized diagnosis in the emergency department (ED). Objective of the review This review aims to summarize and synthesize existing literature on SC to guide its recognition and management in the ED. Discussion SC primarily occurs in elderly or bedbound patients with chronic constipation; however, it does occur in younger patients with comorbidities at increased risk for fecal impaction. Patients may present acutely with abdominal pain and distension, but clinical presentation is often nonspecific and varied, and there are no established diagnostic criteria for SC to date. CT is therefore crucial for diagnosis, revealing key findings such as fecaloma, colonic dilatation, and fat stranding. Treatment depends on severity of illness, ranging from manual disimpaction and other conservative measures for most cases, to surgical intervention for complicated cases, such as stercoral perforation. Conclusions SC can be a challenging diagnosis in the ED, often requiring multidisciplinary collaboration. Timely recognition and appropriate treatment are essential to reduce morbidity and mortality associated with this condition. Further research is needed to establish diagnostic criteria and clear management algorithms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stercoral colitis in the emergency department: a review of the literature

Bae,

Tran,

Shah

2024

Int J Emerg Med

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“…Within the individual case reports were 13 cases of PSC with 3 fatalities [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] . There were 9 cases total of NPSC with 4 fatalities [4] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] . When the NPSC cases were stratified for sepsis, a total of 4 cases with 2 fatalities was yielded [24] , [25] , [26] , [27] .…”

Section: Clinical Discussionmentioning

confidence: 99%

Non-perforated Stercoral Colitis patients with septic shock have a higher mortality than their perforated counterparts. A case report and review of literature

Reátegui

Grubbs²

2022

International Journal of Surgery Case Reports

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“…complication [9]. Bowel regimen typically includes a combination of oral agents such as senna, docusate, MiraLAX, Dulcolax as well as rectal enemas.…”

Section: Introductionmentioning

confidence: 99%

Altered Mental Status as the Primary Presentation of Stercoral Colitis

Himax¹,

Anna²,

Ali³

2021

J Clin Gastroenterol Treat

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Past medical history was significant for dementia and cerebrovascular accident (CVA). On admission, the patient's family was concerned regarding her acute change in mentation given her history of CVAs. Her vitals were significant for tachycardia to 103 beats per minutes. Her labs revealed leukocytosis of 23.4 thousand/mm 3 . Given AMS, Computed tomography (CT) head was obtained which revealed no evidence of acute intracerebral event. CT abdomen was also obtained given her abdominal pain

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Stercoral Colitis: When Constipation is an Emergency

Cited by 4 publications

References 3 publications

Stercoral colitis in the emergency department: a review of the literature

Stercoral colitis in the emergency department: a review of the literature

Non-perforated Stercoral Colitis patients with septic shock have a higher mortality than their perforated counterparts. A case report and review of literature

Altered Mental Status as the Primary Presentation of Stercoral Colitis

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