Ileal Fecaloma Presenting with Small Bowel Obstruction

• Published in: Pediatric gastroenterology, hepatology & nutrition Vol. 18; no. 3; pp. 193 - 196
• Main Authors: Yoo, Ha Yeong, Park, Hye Won, Chang, Seong-Hwan, Bae, Sun Hwan
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 01-09-2015; 대한소아소화기영양학회
• Subjects: Case Report; 소아과학; Abdominal pain; Intestinal obstruction; Feces
• ISSN: 2234-8646; 2234-8840
• DOI: 10.5223/pghn.2015.18.3.193

A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a 4×3×2.5 cm fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.