A 12-cm-diameter Coprolith in the Descending Colon due to Chronic Constipation and Adhesion of the Sigmoid Colon—A Case Report—

Abstract

A 72-year-old woman with a medical history of fecal bowel obstruction and being treated for chronic constipation visited our hospital because of a constant residual fecal mass in the descending colon. Computed tomography (CT) showed a 10-cm coprolith in the descending colon. The coprolith was crushed endoscopically using cola dissolution therapy, and the size was reduced to 7 cm, but complete removal was not possible. During follow-up, the size increased to 12 cm, and surgery was therefore performed to prevent bowel obstruction. Because a barium enema showed poor extension of the sigmoid colon, and operative findings showed adhesion between the colon and uterus and left adnexa, it was thought that the coprolith formed in the descending colon due to obstruction caused by chronic constipation and adhesion of the sigmoid colon. The surgery consisted of partial colectomy including the enterolith and removal of the adhesion. Treatment for enteroliths is surgical when endoscopic treatment is ineffective, but surgery requires not only removal of enteroliths, but also removal of the cause.