TITLE:
An Inahbitual Etiology of Acute Intestinal Obstruction: The Giant Fecalome
AUTHORS:
Leh Bi Kalou Ismaèl, Traoré Mamadou, N’Dri Ahou Bernadette, Ekra Amos Serge, Akowendo Ezéchiel, Kouakou Blaise Amos, Bamba Inza, Kouakou Kouamé Bernadin, Anzoua Kouakou Ibrahim, Lebeau Roger, Diané Bamourou
KEYWORDS:
Intestinal Obstruction, Giant Fecal Impaction
JOURNAL NAME:
Surgical Science,
Vol.14 No.3,
March
27,
2023
ABSTRACT: The authors report an observation of a 20-year-old patient,
who was referred by the medical emergency department for abdominal distention.
The disease would have started with the appearance of abdominal pain, a stop of
materials without stopping gases appeared gradually and evolving for 4 months.
The patient was chronically constipated. She administered daily enemas with
homemade products to have a bowel movement. She never had rectal bleeding, there was no alteration diarrhea—constipation.
Mother of 3 children alive and apparently healthy. On clinical examination
the abdomen was enlarged in size, painless but of firm consistency. The hernial
orifices were free. Hard and abundant stools were noted on digital rectal
examination. The abdominal CT scan revealed a large endorectal fecal impaction
going up into the left colon, an absence of abdominal mass. We retained the
diagnosis of giant fecal impaction. The patient was hospitalized and we
instituted paraffin oil therapy combined with an evacuator enema with glycerin.
The evolution was marked by a resumption of transit in the form of stool and
gas (3 to 4 stools per day). At Day 8 of hospitalization the abdomen had
decreased in volume the transit was regular and the patient was discharged on
Day 10. Reviewed 3 months later, she maintained a regular transit made of one
bowel movement a day. After a setback of 3
years the transit is still preserved. The authors discuss the
etiologies of fecal impaction and their respective treatments.