Clin Endosc.  2012 Jun;45(2):174-176. 10.5946/ce.2012.45.2.174.

Cecal Fecaloma Due to Intestinal Tuberculosis: Endoscopic Treatment

• Kim SM
• Ryu KH
• Kim YS
• Lee TH
• Im EH
• Huh KC
• Choi YW
• Kang YW

• KMID: 2048858
• DOI: http://doi.org/10.5946/ce.2012.45.2.174

Abstract

Colorectal fecaloma is a mass of accumulated feces that is much harder in consistency than a fecal impactation. The rectosigmoid area is the common site for fecalomas and the cecum is the most unusual site. Diagnosis is usually made by distinctive radiographic findings of a mobile intraluminal mass with a smooth outline and no mucosal attachment. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, endoscopic procedures or a surgical intervention may be needed. We report here that a cecal fecaloma caused by intestinal tuberculosis scar was successfully removed by endoscopic procedures.

Keyword

Fecaloma; Intestinal tuberculosis; Cecum; Endoscopic treatment

MeSH Terms

Cecum
Cicatrix
Enema
Feces
Laxatives
Tuberculosis
Laxatives

Figure

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  Fig. 1 An abdominal computed tomography scan (A, axial view; B, coronal view) shows a 3.0-cm, round, laminated intraluminal mass with calcification in the cecum.

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  Fig. 2 Colonoscopy reveals a fibrotic scar and a web-like stricture in the cecum with a yellowish mass in a blind space which was formed by stricture.

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  Fig. 3 Endoscopic balloon dilatation with a through-the-scope balloon.

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  Fig. 4 (A) Colonoscopic view of breaking down the fecaloma with a polypectomy snare. (B) Colonoscopy reveals the lumen of the cecum after the fecaloma was successfully removed by the endoscopic procedure.

Reference

1. Garisto JD, Campillo L, Edwards E, Harbour M, Ermocilla R. Giant fecaloma in a 12-year-old-boy: a case report. Cases J. 2009; 2:127. PMID: 19196473.

2. Cid AA, Pietruk T, Bidari CZ, Ehrinpreis MN. Cecal fecaloma mimicking colonic neoplasm. Dig Dis Sci. 1981; 26:1134–1137. PMID: 7307862.

3. Gilbert RF. Cecal infarction secondary to a distal obstructing fecaloma: association with drug abuse. South Med J. 1980; 73:1296–1297. PMID: 6106293.

4. Lasser A, Conte M, Solitare GB. Stercoraceous perforation of the cecum: report of two cases. Dis Colon Rectum. 1975; 18:410–412. PMID: 1157644.

5. Kantarci M, Fil F. Education and imaging. Gastrointestinal: fecaloma in a dilated sigmoid colon. J Gastroenterol Hepatol. 2007; 22:955. PMID: 17565653.

6. Sakai E, Inokuchi Y, Inamori M, et al. Rectal fecaloma: successful treatment using endoscopic removal. Digestion. 2007; 75:198. PMID: 17893439.

7. Freud WI, Zikmund A, Stroud CS, Fries JW. Fecaloma: report of a case and review of the literature. Gastroenterology. 1955; 29:446–452. PMID: 13262500.

8. Kim KH, Kim YS, Seo GS, Choi CS, Choi SC. A case of fecaloma resulting in the rectosigmoid megacolon. Korean J Neurogastroenterol Motil. 2007; 13:81–85.

9. Campbell JB, Robinson AE. Hirschsprung's disease presenting as calcified fecaloma. Pediatr Radiol. 1973; 1:161–163. PMID: 4773697.

10. Araki T, Miki C, Yoshiyama S, Toiyama Y, Sakamoto N, Kusunoki M. Total proctocolectomy and ileal J-pouch anal anastomosis for chagasic megacolon with fecaloma: report of a case. Surg Today. 2006; 36:277–279. PMID: 16493541.

11. Knobel B, Rosman P, Gewurtz G. Bilateral hydronephrosis due to fecaloma in an elderly woman. J Clin Gastroenterol. 2000; 30:311–313. PMID: 10777195.