A Case of Fecal Intestinal Obstruction in the Right-sided Colon Presented with Eosinophil Infiltration

Abstract

A 49-year-old woman presented with a two-day history of orbital pain and right lower abdominal pain. Computed tomography of the abdomen revealed fecal impaction in the ascending colon, causing intestinal obstruction. The patient was treated conservatively, however, no symptomatic remission was gained. Therefore, computed tomography was performed again 4 days after the first medical examination. The feces had migrated to the transverse colon, and obstructive enterocolitis had occurred in the proximal colon. The patient was urgently admitted to our hospital and diagnosed with fecal intestinal obstruction and stercoral colitis. A lower gastrointestinal endoscopy revealed mucosal necrosis, and the patient was referred for emergency surgery. The patient underwent an open right hemicolectomy. Histopathology revealed an inflammatory cell infiltrate characterized by eosinophilic infiltration of the intrinsic muscularis propria and intermuscular plexus of the colon at the obstruction site. It is rare that fecal intestinal obstruction occurs in the right (-sided?) colon. Eosinophil infiltration of the intestinal tract has resulted in colonic obstruction in some cases. This case report demonstrates a fecal intestinal obstruction with eosinophil infiltration of the intestinal wall.