Ann Coloproctol.  2021 Oct;37(5):346-348. 10.3393/ac.2021.00206.0029.

Endoscopic Removal of a Fecalith or Fecomucolith in a Rectal Stump or Pouch

• Yeap E
• Ratinam R
• Arachchi A
• Lim J
• Tay YK
• Duieb Z

• KMID: 2521905
• DOI: http://doi.org/10.3393/ac.2021.00206.0029

Abstract

Fecaliths or fecomucoliths can form in rectal stumps after a Hartmann procedure or in a coloneovaginal conduit. They can cause significant distress to the patient by causing symptoms such as discharge and odor. We describe a novel and effective method of endoscopic obliteration and removal where other techniques such as removal during examination under anesthesia or serial enemas have failed. By using a combination of hydrodissection with a saline injector gun and biopsy forceps and a polypectomy snare to break down the fecomucolith or fecalith, this troublesome problem can be resolved endoscopically. Successful removal of the fecalith/fecomucolith and resolution of the symptoms for the patients were achieved. No complications are reported. We describe an effective and novel method for endoscopic removal of fecaliths and fecomucoliths.

Keyword

Gastrointestinal endoscopy; Fecalith; Colonoscopy