Abstract：
BACKGROUND:Stercoral colitis is a rare inflammatory process involving the colonic wall secondary to fecal impaction with high morbidity and mortality; especially if complicated with ischemic colitis, stercoral ulcer formation and subsequent perforation. There are several case reports published on abdominal perforation resulting from stercoral colitis. However, stercoral colitis complicated by ischemic colitis is rare. The purpose of this case report is to describe the potential challenges in the diagnosis and management of stercoral colitis with ischemic colitis. CASE PRESENTATION:An 87 years old male with history of chronic constipation presents with severe abdominal pain to the emergency department. The patient was hemodynamically stable. On physical examination, the abdomen was mildly distended with moderate tenderness. Lab work was significant for leukocytosis and lactic acidosis. Abdominal CT scan revealed large amount of retained stool in the colon, bowel wall thickening and infiltration of peri-colonic fat, which were suggestive for stercoral colitis. Patient was started on IV fluids and antibiotics. He was given an enema, followed by laxative and manual disimpaction of stool. Colonoscopy was performed and biopsies were obtained. Tissue biopsy was significant for focal active colitis with regenerative glandular changes and neural hyperplasia. CONCLUSION:Elevated lactic acid level secondary to ischemia of the bowel wall with CT scan findings aid in establishing the diagnosis of stercoral colitis complicated with ischemic colitis. Urgent treatment with laxatives and fecal disimpaction is indicated to prevent perforation and peritonitis.
journal_name
BMC Gastroenteroljournal_title
BMC gastroenterologyauthors
Naseer M,Gandhi J,Chams N,Kulairi Zdoi
10.1186/s12876-017-0686-6subject
Has Abstractpub_date
2017-11-28 00:00:00pages
129issue
1issn
1471-230Xpii
10.1186/s12876-017-0686-6journal_volume
17pub_type
杂志文章abstract：BACKGROUND:Mini-Mental State Examination (MMSE) is one of the most commonly used methods in the assessment of cognitive mental status. MMSE has been used in hepatology but its usefulness in the evaluation of hepatic encephalopathy (HE) has never been properly assessed. The aim of the study was to investigate the value ...
journal_title：BMC gastroenterology
pub_type： 临床试验,杂志文章
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pub_type： 杂志文章
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pub_type： 杂志文章,meta分析,评审
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journal_title：BMC gastroenterology
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pub_type： 杂志文章
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pub_type： 杂志文章
doi：10.1186/s12876-014-0211-0
更新日期：2014-12-10 00:00:00
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pub_type： 杂志文章
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