Constipation with faecal impaction is a common condition, which may lead to serious potential complications. Among such complications, stercoral perforation has been rarely reported in the literature. We report a single case of 75-year-old woman, with a massive faecal impaction, which resulted in a rectum perforation, presented as a pneumoperitoneum, pneumomediastinum and subcutaneous emphysema. We present this case to remind physicians that neglected accumulation of faecal matter in the rectum may lead to ischemia and perforation of the colon and rectum. This case illustrates that severe chronic constipation requires adequate management, including disimpaction and aggressive medical treatment. Appropriate operative treatment may be life-saving.
Department of Emergency Management, Gurutzeta Hospital, Basque Health Service, Gurutzetako enparantza z.g., Barakaldo, Bizkaia, Spain
Correspondence to Dr Eunate Arana-Arri, PhD, MD, Gurutzeta Hospital, Basque Health Service, Gurutzetako enparantza z.g., Barakaldo, Bizkaia 48903, Spain
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Received 3 October 2006 Accepted 27 January 2007