Pediatr Gastroenterol Hepatol Nutr.  2013 Sep;16(3):200-205. 10.5223/pghn.2013.16.3.200.

Acute Urinary Retention in a 47-month-old Girl Caused by the Giant Fecaloma

• Park JS
• Park TJ
• Hwa JS
• Seo JH
• Park CH
• Youn HS

• KMID: 2051335
• DOI: http://doi.org/10.5223/pghn.2013.16.3.200

Abstract

We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspissated feces in the colon or rectum giving the appearance of an abdominal mass. A fecaloma can be developed by diverse causes and the causes of the fecaloma in this case were septum reformation after the Duhamel procedure and long-term constipation. Chronic constipation is very common at outpatient clinic. However, acute urinary retention and voiding difficulty caused by fecaloma in the giant Duhamel pouch has never been reported in Korea. We would like to present our case with acute urinary retention due to a fecaloma and suggest that fecaloma might be considered as one of the causes for acute urinary retention, especially in cases with previous Duhamel operation for repair of Hischsprung disease.

Keyword

Urinary retention; Hirschsprung disease; Fecaloma

MeSH Terms

Ambulatory Care Facilities
Colon
Constipation
Feces
Female
Hirschsprung Disease
Humans
Hydronephrosis
Korea
Preschool Child
Rectum
Stress, Psychological
Urinary Bladder Neck Obstruction
Urinary Retention

Figure

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  Fig. 1 Simple abdominal X-ray shows faint rectal gas and a large amount of fecal materials in the distal colon (circle).

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  Fig. 2 Both hydronephrosis (A, B) and a distended bladder (C) were noted on abdominal ultrasonography.

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  Fig. 3 Coronal (A) and saggital views (B) of whole abdominal computed tomography show that the distal part of the colon is markedly dilated and contains heterogeneous materials consisting of impacted feces (lined arrows). The markedly dilated distal colon was suspected as Duhamel's pouch. The upward displaced bladder and internal Foley catheter are noted (dotted arrows).

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  Fig. 4 The giant Duhamel pouch with fecal materials (arrow) without stenosis of the anastomotic site was noted on the colon study.

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