Persistent megacolon that results from frequent episodes of fecal impaction without adequate treatment is a rare and seldom reported condition in the elderly. This report discusses a 72-year-old white woman presenting with a large abdominal mass, who had at least 4 episodes of radiographically demonstrated fecal impaction over the previous year without adequate treatment. The patient required hospitalization for a bleeding rectal ulcer during the second episode of fecal impaction. Computed tomography (CT) scans on this admission revealed a dilated colon up to 16 x 14 cm in maximal dimensions extending over 30 cm, filled with massive fecal material. Several follow-up abdominal radiographs revealed a persistent megacolon after 10 months despite the absence of significant fecal material in the rectosigmoid colon. While multiple contributing factors were likely involved in her frequent fecal impactions, the clinical course of this case suggests that frequent fecal impactions without adequate treatment can lead to megacolon in high-risk patients. Clinicians should aggressively treat fecal impaction and monitor the adequacy of treatment with abdominal radiography in order to avoid significant complications. Complications and management of fecal impaction and the pathophysiology of megacolon in the literature are reviewed and discussed.
"Periodic enema may be required for some patients in long-term care.9 Radiographic study may be necessary to monitor the adequacy of treatment, especially in patients with recurrent fecal impaction.10 When fecal impaction is present, a limited enema study with a water-soluble contrast agent can outline the colon and fecal mass and rule out other diseases without aggravating the condition. "
[Show abstract][Hide abstract] ABSTRACT: Fecal impaction is a disorder characterized by a large mass of compacted feces in the rectum and/or colon, which cannot be evacuated. For mild and moderate fecal impaction, recommended treatments include stool softeners, oral mineral and olive oil, and edema; for severe fecal impaction, manual removal is needed and sometimes laparotomy may be indicated if medical therapies are not effective. Here we report a case with severe fecal impaction who did not defecate for 75 days. We treated this patient with vegetable oil, Chinese traditional medicine and enema in sequence. After 12 days of therapy, she evacuated hard fecal masses, and the symptoms were relieved.
Journal of neurogastroenterology and motility 04/2010; 16(2):199-202. DOI:10.5056/jnm.2010.16.2.199 · 2.30 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The usable capacity in the fiber is limited by the operating windows in the different bands. Within these constraints, the cost of the WDM line at high capacities is directly dependent on the spectral efficiency, which can be defined as the ratio of the bit rate per channel to the inter-channel spacing. The higher the spectral efficiency is, the higher is the capacity that can be packed into a single fiber.
Optical Fiber Communication Conference and Exhibit, 2002. OFC 2002; 04/2002
[Show abstract][Hide abstract] ABSTRACT: We report a case of sudden death due to a catastrophic spontaneous rupture of a urinary bladder associated with megacolon due to a fecal impaction (fecaloma). The massively distended rectum and sigmoid colon filled the pelvic cavity and pressed up against the posterior aspects of the uterus, vagina, and urinary bladder. This produced bladder outlet obstruction, followed by massive dilatation and rupture of the urinary bladder, bilateral hydronephrosis, and a 3.5 liter collection of urinary fluid within the abdominal cavity. Complications of chronic constipation, fecalomas, and rupture of the urinary bladder are reviewed.
The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 10/2009; 30(3):280-3. DOI:10.1097/PAF.0b013e318187e085 · 0.70 Impact Factor
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