Abstract
An 81-year-old woman complaining of abdominal bloating and being unable to defecate was evaluated. Abdominal CT showed obstruction due to fecal impaction in the sigmoid colon and dilation of the colon proximally. However, there was no evidence of bowel ischemia or peritonitis. The WBC count was increased to 30,000/μl, and bacterial translocation associated with colonic obstruction was suspected.
The patient's general condition was stable, so colonoscopy was performed during elective/urgent surgery. The fecal impaction was relieved with a water-soluble contrast enema, but because of the large amount of feces, the patient was carefully monitored. Abdominal CT on the following day showed bowel wall edema, but there was no peritonitis or shock, and the blood test findings improved rapidly. Colonoscopy on hospital day 7 showed multiple discontinuous ulcers of the transverse-sigmoid colon and evidence of healing of the obstructive colitis. This condition has not recurred during follow-up since the patient was discharged.
Successful endoscopic treatment of obstructive colitis due to fecal impaction has rarely been reported. This case is reported along with a comparison with other similar surgical cases in Japan.
