Un fécalome géant compliqué d’un volvulus et d’une perforation colique bifocale
Stercoral perforation of the colon is rare and usually occurs in elderly patient suffering from chronic constipation. It can also occur in younger patient. The authors report on the case of a 42-year-old patient who presented to emergency department with acute abdomen. Initial resuscitation was performed and the patient underwent urgent laparotomy. He was found to have a massive fecal impaction which extended from the rectum to right flexure of the colon and resulted primarily in feculent peritonitis, which lead to a double perforation of the sigmoid colon and the transverse colon, and secondarily in a volvulus of the sigmoid colon. The patient underwent left hemicolectomy with Hartmann colostomy. He died two days after surgery. The size of the fecaloma together with the double perforation and the volvulus of the sigmoid colon make the interest in this case, which is never reported in the literature, at least to our knowledge.
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