Rare case of fecal impaction caused by a fecalith originating in a large colonic diverticulum: A case report  

作　　者：Hiroki Tanabe Kazuyuki Tanaka Mitsuru Goto Tomonobu Sato Keisuke Sato Mikihiro Fujiya Toshikatsu Okumura 

机构地区：[1]Division of Gastroenterology and Hematology/Oncology,Department of Medicine,Asahikawa Medical University,Asahikawa 078-8510,Hokkaido,Japan [2]Department of Gastroenterology,Asahikawa Kousei Hospital,Asahikawa 078-8211,Hokkaido,Japan [3]Department of Pathology,Asahikawa Kousei Hospital,Asahikawa 078-8211,Hokkaido,Japan

出　　处：《World Journal of Clinical Cases》2021年第2期416-421,共6页世界临床病例杂志

摘　　要：BACKGROUND Fecal impaction is defined as a large mass of compacted feces in the colon and has the potential to induce a serious medical condition in elderly individuals.Fecal impaction is generally preventable,and early recognition of the typical radiological findings is important for making an early diagnosis.The factors that lead to fecal impaction are usually similar to those causing constipation.Few cases with fecal impaction associated with a diverticulum have been reported.CASE SUMMARY We present the case of a 62-year-old woman who suffered from abdominal pain and vomiting,had a medical history of repeated acute abdomen and was diagnosed with fecal impaction in the descending colon based on X-ray and computed tomography(CT)imaging.After examination by gastrografinenhanced colonography following colonoscopy and CT colonography,the fecalith was suspected to have been produced at the site of a large diverticulum in the transverse colon.The fecalith was surgically resected,and a histological diagnosis of pseudodiverticulum was made.There was no recurrence during 33 mo of follow-up.CONCLUSION This case highlights the importance of accurate identification and treatment of a fecal impaction.This case indicated that the endoscopic evacuation and subsequent colonography were effective for identifying a diverticulum that might have caused fecal impaction.A fecal impaction was associated with the diverticulum.Consequently,the planned diverticulectomy was performed.Appropriate emergency medical treatment and maintenance treatments should be selected in such cases to prevent recurrence.

关 键 词：Colonic ileus CONSTIPATION Acute abdomen Computed tomography colonography Case report Colonoscopy 

分 类 号：R574.62[医药卫生—消化系统]