Abstract

Case Report

Stercoral perforation: A rare case and review

Lava Krishna Kannappa*, Muhammad Sufian Khalid, May Hnin Lwin Ko, Mohsin Hussein, Jia Hui Choong, Ameer Omar Rawal-Pangarkar, Danaradja Armugam and Yahya Salama

Published: 28 October, 2019 | Volume 3 - Issue 1 | Pages: 049-051

We present a 54-year-old male with abdominal pain, Vomiting and weight loss since 5 months. Perforation was noted at recto-sigmoid junction and underwent Hartman’s procedure with end colostomy. Histology of sigmoid colon confirmed a Stercoral perforation without any evidence of dysplasia or malignancy. Patient had chemotherapy for squamous cell carcinoma (SCC) of epiglottis a year ago and was on codeine phosphate and Oromorph as and when required since his treatment for SCC for pain. Patient also had been suffering from constipation since he finished chemotherapy. Stercoral perforation always need to kept in mind in patients who present with constipation and need to take all patients who present with chronic constipation and initiate measures we encounter commonly in everyday practice. We present a brief review about Stercoral perforation and its management.

Read Full Article HTML DOI: 10.29328/journal.acst.1001009 Cite this Article Read Full Article PDF

References

  1. Berry J. Dilatation and rupture of sigmoid flexure short report. BR Med J. 1894; 1: 301.
  2. Heffernan C, Pachter HL, Megibow AJ, Macari M. Stercoral colitis leading to fatal peritonitis: CT findings. AJR Am J Roentgenol. 2005; 184: 1189-1193. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15788592
  3. Serpell JW, Nicholls RJ. Stercoral perforation of the colon. Br J Surg. 1990; 77: 1325-1329.
  4. Maurer CA, Renzulli P, Mazzucchelli L, Egger B, Seiler CA, et al. Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon. Dis Colon Rectum. 2000; 43: 991-998. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10910249
  5. Tokunaga Y, Hata K, Nishitai R, Kaganoi J, Nanbu H, et al. Spontaneous perforation of the rectum with possible stercoral etiology: Report of a case and review of the literature. Surg Today. 1998; 28: 937-939. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9744404
  6. Moon JY, Hong SS, Hwang J, et al. Differentiation between stercoral perforation and colorectal cancer perforation. Rev Assoc Med Bras (1992). 2019; 65: 191-197.
  7. Kumar P, Pearce O, Higginson A. Imaging manifestations of faecal impaction and stercoral perforation. Clin Radiol. 2011; 66: 83-88. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21147303
  8. Tateno F, Sakakibara R, Aiba Y, Tsuyusaki Y, Kishi M, et al. Stercoral ulcer and colonic perforation in an individual with parkinson's disease with constipation. J Am Geriatr Soc. 2016; 64: e118-e120. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27701730
  9. Tessier DJ, Harris E, Collins J, Johnson DJ. Stercoral perforation of the colon in a heroin addict. Int J Colorectal Dis. 2002; 17: 435-437.
  10. Linder F, Graf W, Edholm D. Letter to the editor: Stercoral perforation of the sigmoid colon possibly associated with anticholinergic drugs or opiates: A case series. Int J Colorectal Dis. 2016; 31: 1383-1384.
  11. Patel VG, Kalakuntla V, Fortson JK, Weaver WL, Joel MD, et al. Stercoral perforation of the sigmoid colon: Report of a rare case and its possible association with nonsteroidal anti-inflammatory drugs. Am Surg. 2002; 68: 62-64. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12467320
  12. Kang J, Chung M. A stercoral perforation of the descending colon. J Korean Surg Soc. 2012; 82: 125-127. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22347716
  13. Sykes EM Jr. Colon perforation in ehlers-danlos syndrome. Report of two cases and review of the literature. Am J Surg. 1984; 147: 410-413. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6367507
  14. Huang WS, Wang CS, Hsieh CC, Lin PY, Chin CC, et al. Management of patients with stercoral perforation of the sigmoid colon: Report of five cases. World J Gastroenterol. 2006; 12: 500-503. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16489660
  15. Bunkar SK, Singh A, Singh RP. Stercoral perforation of the sigmoid colon in a schizophrenic patient. J Clin Diagn Res. 2015; 9: PD07-PD08. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25738027
  16. Chakravartty S, Chang A, Nunoo-Mensah J. A systematic review of stercoral perforation. Colorectal Dis. 2013; 15: 930-935. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23331762
  17. Serpell JW, Sen M, Giddins G, Nicholls RJ, Bradfield WJ. Stercoral perforation of the colon proximal to an end colostomy. Postgrad Med J. 1991; 67: 299-300. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2062783
  18. Hussain ZH, Whitehead DA, Lacy BE. Fecal impaction. Curr Gastroenterol Rep. 2014; 16: 404-414.
  19. Gough AE, Donovan MN, Grotts J, Greaney GC. Perforated stercoral ulcer: A 10-year experience. J Am Geriatr Soc. 2016; 64: 912-914. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27100603

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?