Fecaloma: obstruction of the intestine
Refers to a mass of accumulated stools associated with the fecal group. Fecalomas are usually found in the area of the rectum and colon.
Chronic constipation causes a mechanical obstruction that evolves rapidly in the small intestine. Most fecalomas are treated successfully by conservative methods, such as laxatives, enemas, and rectal evacuation.
When conservative treatments have failed, surgical intervention may be necessary. A fecaloma is usually found in the sigmoid colon or rectum but rarely in the blind colon.
Despite fecal retention that is frequent and problematic, a fecaloma is a sporadic form of impaction, about an accumulation of fecal matter that forms a mass separated from other intestinal contents.
Hirschsprung’s disease, Chagas disease, inflammatory diseases, neoplastic diseases, and psychiatric diseases, among others, have also been discovered in patients suffering from chronic constipation.
They most commonly occur in the area of the rectum and sigmoid colon; In the small intestine, it is unusual. This can be explained by the fact that the stools in the left colon are firmer than those in other areas because the diameter of the colon is narrower to the left than to the right.
Fecaloma symptoms are usually nonspecific, including the type of “overflow” of diarrhea, constipation, weight loss, and abdominal discomfort after meals.
The diagnosis of fecaloma is usually made radiologically when the characteristic intraluminal mass is observed on plain radiographs, barium enema, or abdominal CT.
Such masses have smooth margins and are not attached to the surface of the mucosa, thus moving within the intestinal lumen. Serious complications can occur at any time, such as colon obstruction, perforation, sciatica, urethral obstruction, secondary hydronephrosis, and deep vein thrombosis.
Commonly, fecalomas can be treated with conservative methods, such as laxatives, enemas, and digital evacuation (digital stimulation). However, surgical intervention may be necessary to eliminate fecaloma in some intractable cases.