Abstract
A case of a fecalith associated with rectocele in a 51-year-old woman is described. The patient was ad-mitted with difficulty of defecation and incomplete rectal evacuation for 10 years. Upon physical examination, rectocele was observed. Colonoscopy and barium enema showed a fecalith approximately 5 cm in diameter in the rectum. The fecalith was extracted endoscopically under lumbar anesthesia. The fecalith was composed of inspissated feces. Subsequent videodefecography revealed a large rectocele 5-6 cm in depth and barium trapping during straining. The patient was initially managed with conservative treatments including laxatives and biofeedback training, but these treatments failed. Two months later, a fecalith of approximately the same size recurred. Finally, the patient underwent surgical repair. Her symptom was resolved and bowel movement was normalized. In the 5 years after operation, no fecalith has recurred. According to our knowledge, this is the first case with fecalith formation in the rectocele and confirmed on videodefecography.
