170 results on '"Fecal Impaction surgery"'
Search Results
2. Endoscopic Removal of an Obstructing Fecolith at the Entrance of Appendix.
- Author
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Yan L, Li D, Liu D, and Liu B
- Subjects
- Humans, Fecal Impaction surgery, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Male, Female, Colonoscopy methods, Intestinal Obstruction etiology, Intestinal Obstruction surgery, Intestinal Obstruction diagnostic imaging, Appendix surgery, Appendix diagnostic imaging
- Published
- 2024
- Full Text
- View/download PDF
3. Cholangioscope-assisted endoscopic retrograde appendicitis therapy for the treatment of appendicitis complicated with fecal stones: a case report.
- Author
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Zhao Q, Wang R, Sun M, and Zhao S
- Subjects
- Adult, Humans, Cholangiopancreatography, Endoscopic Retrograde methods, Fecal Impaction complications, Fecal Impaction therapy, Fecal Impaction surgery, Fecal Impaction diagnostic imaging, Appendicitis surgery, Appendicitis complications
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2024
- Full Text
- View/download PDF
4. Endoscopic Diverticular Ridge Myotomy to Treat Acute Colonic Diverticulitis Caused by Impacted Fecalith.
- Author
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Mao L and Zhang Q
- Subjects
- Humans, Myotomy methods, Fecal Impaction surgery, Fecal Impaction complications, Male, Treatment Outcome, Radiography, Abdominal, Aged, Female, Diverticulitis, Colonic surgery, Diverticulitis, Colonic complications
- Published
- 2024
- Full Text
- View/download PDF
5. Endoscopic removal of a huge cecum fecalith hidden behind the ileocecal stricture in a patient with Crohn's disease.
- Author
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Lu Y, Huang L, and Sun J
- Subjects
- Humans, Constriction, Pathologic etiology, Cecum surgery, Ileum, Crohn Disease complications, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Fecal Impaction surgery
- Abstract
Competing Interests: Disclosure All authors disclosed no financial relationships. Commentary Fibrostenotic disease is common in Crohn’s disease, and it is estimated that 50% of Crohn’s disease patients will experience fibrotic strictures over their lifetime. Unfortunately, antifibrotic drugs in inflammatory bowel disease (IBD) are scarce, and endoscopic or surgical intervention is often required. In this case, the authors describe a patient with Crohn’s disease with a colonic stricture proximal to the cecum. The stricture was further complicated by a large fecalith causing abdominal pain and was best seen on intestinal US. This highlights the expanding role of intestinal US not only in evaluating disease activity in IBD but also in the ability to identify subtle abnormalities such as fecaliths that may develop as a result of IBD adverse events. To remove the fecalith, cecal access was required and was accomplished by endoscopic electrosurgical IT2 knife stricturotomy. Reported endoscopic stricturotomy advantages over endoscopic balloon dilation include lower rate of strictures restenosis and need for subsequent surgery. Previous studies have also shown endoscopic stricturotomy to have relatively low adverse event rates of bleeding and perforation even when compared with endoscopic balloon dilation. Additionally, as in this case, it is possible that balloon dilation may be inadequate to accomplish the removal of large objects such as a 4- to 4.5-cm fecalith. After endoscopic stricturotomy, successful removal of the large fecalith hidden behind the lumen stricture resulted in resolution of abdominal symptoms. Courtney Walker, DO, Advanced Endoscopy Fellow, Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Denver, Colorado, USA Amy Tyberg, MD, FASGE, FACG, Associate Editor for Focal Points
- Published
- 2024
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6. Laser lithotripsy for the treatment of a giant fecalith obstructing a colorectal anastomosis.
- Author
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Fossmark R, Dalsbø PL, Rokseth KM, and Hauso Ø
- Subjects
- Humans, Anastomosis, Surgical adverse effects, Fecal Impaction diagnostic imaging, Fecal Impaction surgery, Lithotripsy, Laser, Intestinal Obstruction surgery, Colorectal Neoplasms surgery, Lithotripsy
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2023
- Full Text
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7. Endoscopic Appendiceal Orifice Myotomy to Remove an Impacted Appendiceal Fecalith.
- Author
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Mao L, Lu X, and Zhang Q
- Subjects
- Humans, Endoscopy, Treatment Outcome, Fecal Impaction surgery, Appendix surgery, Intestinal Obstruction, Myotomy, Esophageal Achalasia
- Published
- 2023
- Full Text
- View/download PDF
8. Chronic constipation that resulted in fecal impaction and colon perforation: A case report.
- Author
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Alburakan A, Alshunaifi A, AlRabah R, Alshammari S, Alnasser S, and Nouh T
- Subjects
- Adult, Constipation complications, Female, Fundoplication methods, Humans, Treatment Outcome, Colonic Diseases surgery, Deglutition Disorders etiology, Esophageal Achalasia surgery, Fecal Impaction complications, Fecal Impaction surgery, Intestinal Perforation diagnosis, Intestinal Perforation etiology, Intestinal Perforation surgery, Laparoscopy methods, Peritonitis diagnosis, Peritonitis etiology, Peritonitis surgery
- Abstract
Rationale: Gastrointestinal (GI) motility disorders represent a set of variable presentations caused by an abnormal functioning enteric neuromusculature. Any part of the GI tract can be affected, and depending on the organ involved, the patient presentation will differ., Patient Concerns: A 26-years old female who had a history of laparoscopic Heller myotomy 15 years ago for progressive dysphagia. She presented with peritonitis and sigmoid colon perforation secondary to severe chronic constipation. Later after undergoing Hartman procedure, she continued to have significant constipation. In addition, she reported progressive dysphagia and regurgitation to both solids and liquids., Diagnosis: An esophageal manometry revealed Achalasia type 3, and stomach motility nuclear study showed mild delay in gastric emptying., Interventions: Initially, Hartmann procedure was performed. Afterward, we performed a reversal of Hartman, robotic redo of Heller myotomy, and Dor fundoplication was performed., Outcomes: The patient had an uneventful postoperative course and was discharged in good condition., Lessons: Our case highlights an unusual presentation of GI motility disorder resulting in peritonitis from sigmoid colon perforation. Early recognition and prompt treatment of GI motility disorders are essential to avoid severe complications., Competing Interests: The authors do not have any conflict of interest or funding source to declare., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
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9. Modern Management of the Appendix: So Many Options.
- Author
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Grasso CS and Walker LA
- Subjects
- Age Factors, Algorithms, Anti-Bacterial Agents therapeutic use, Appendectomy methods, Appendicitis complications, Appendicitis surgery, Appendix diagnostic imaging, Appendix surgery, Clinical Decision-Making, Colonoscopy, Fecal Impaction surgery, Humans, Laparoscopy, Time Factors, Appendiceal Neoplasms diagnosis, Appendicitis therapy
- Abstract
Nonoperative management (NOM) of acute appendicitis is becoming more popular, especially in resource-strapped locations, to minimize hospital system costs. In uncomplicated cases of appendicitis, NOM can effectively treat the patient. It does carry a 39.1% risk of recurrence in 5 years, and operative management (OM) does not increase morbidity or risk of complication, so the authors recommend laparoscopic OM for uncomplicated appendicitis. For complicated cases of appendicitis, the authors recommend initial NOM with interval appendectomy in all patients. All appendicitis patients should undergo surveillance endoscopy if older than 40 years to rule out a contributing neoplasm., Competing Interests: Disclosure The authors have nothing to disclose., (Published by Elsevier Inc.)
- Published
- 2021
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10. Stercoral perforation requiring a total colectomy: a challenging and extreme case.
- Author
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Hoff J, Castrisos G, Sivasuthan G, Ho YM, Zalewska K, and Kapadia C
- Subjects
- Colectomy, Humans, Colonic Diseases surgery, Fecal Impaction diagnostic imaging, Fecal Impaction surgery, Intestinal Perforation etiology, Intestinal Perforation surgery
- Published
- 2021
- Full Text
- View/download PDF
11. Stercoral Colitis: When Constipation is an Emergency.
- Author
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Panneerselvam S, Carlson JJ, and Lin D
- Subjects
- Adult, Colitis etiology, Colitis surgery, Constipation etiology, Constipation surgery, Fecal Impaction complications, Fecal Impaction surgery, Female, Humans, Colitis diagnostic imaging, Constipation diagnostic imaging, Emergency Medical Services methods, Fecal Impaction diagnostic imaging
- Published
- 2021
- Full Text
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12. Hepatic abscess: An uncommon complication after laparoscopic appendectomy.
- Author
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Assenza M, Ciccarone F, Santillo S, Mazzarella G, De Meis E, Bracchetti G, Storace CB, and Corona M
- Subjects
- Anti-Bacterial Agents therapeutic use, Appendix surgery, Drainage, Fecal Impaction complications, Fecal Impaction surgery, Female, Humans, Laparoscopy adverse effects, Reoperation, Young Adult, Abdominal Abscess surgery, Appendectomy adverse effects, Appendicitis surgery, Liver Abscess, Pyogenic etiology, Liver Abscess, Pyogenic therapy
- Abstract
Aim: Laparoscopic appendectomy is currently the treatment of choice for acute appendicitis in emergency setting. When appendicitis is clinically suspected, an appendicolith can be found in 30% of the patients. Retained or dropped appendicoliths are an uncommon complication that may occur as a consequence of stone expulsion from the appendix, before or during laparoscopic appendectomies. This is very rare with only 30 reported cases of intra-abdominal abscess secondary to an appendicolith in the literature over the past 40 years. The objective of this case report is to illustrate an intrahepatic localization of a dropped appendicolith causing liver abscess., Case Presentation: A 23-year-old female was admitted to the emergency department of our hospital for an acute appendicitis with coprolite obstructing the lumen and periappendicular effusion. Laparoscopic appendectomy was performed. Persistent liver abscess due to appendicolith was a rare complication treated by percutaneous drainage. The appendicolith was successfully removed from the liver parenchyma by Dormia basket recovery system., Discussion: Treatment options include percutaneous, open, or laparoscopic drainage of the abscess and retrieval of the fecalith, as antibiotics and drainage alone are usually insufficient., Conclusion: Only a handful of cases of hepatic abscess formation as a result of dropped appendicoliths have been reported in literature. Our proposal of treatment was the percutaneous approach. There was no need for a surgical procedure to remove the intrahepatic appendicolith., Key Words: Dormia basket, Intrahepatic abscess, Laparoscopic appendectomy, Percutaneous drainage.
- Published
- 2021
13. Unexpected cause of acute abdomen in a young healthy woman: the stercoral perforation.
- Author
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Segalini E, Giuliani D, and Monti M
- Subjects
- Female, Humans, Abdomen, Acute etiology, Colonic Diseases, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Fecal Impaction surgery, Intestinal Perforation diagnostic imaging, Intestinal Perforation etiology
- Published
- 2020
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14. Faecal loading and antipsychotics: a case study on severe bowel obstruction.
- Author
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Steen C, Lim K, Scott M, Chua J, and An V
- Subjects
- Anxiety Disorders drug therapy, Depression drug therapy, Fatal Outcome, Fecal Impaction chemically induced, Fecal Impaction diagnostic imaging, Humans, Intestinal Obstruction surgery, Laparotomy methods, Male, Middle Aged, Multiple Organ Failure complications, Tomography, X-Ray Computed methods, Antipsychotic Agents adverse effects, Fecal Impaction surgery, Intestinal Obstruction chemically induced, Schizophrenia drug therapy
- Published
- 2020
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15. A 24-Year-Old Man With Chronic Constipation and Acute Urinary Retention.
- Author
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Mouchli M, Grider DJ, and Rubio M
- Subjects
- Chronic Disease, Colon diagnostic imaging, Colon surgery, Fecal Impaction diagnostic imaging, Fecal Impaction surgery, Humans, Intestinal Mucosa pathology, Male, Tomography, X-Ray Computed, Young Adult, Constipation etiology, Hirschsprung Disease diagnosis, Urinary Retention etiology
- Published
- 2019
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16. Risk Factors for Perforated Appendicitis in the Acute Care Surgery Era-Minimizing the Patient's Delayed Presentation Factor.
- Author
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Kulvatunyou N, Zimmerman SA, Joseph B, Friese RS, Gries L, O'Keeffe T, Stroster JA, and Tang AL
- Subjects
- Adolescent, Adult, Age Factors, Appendicitis complications, Emergency Service, Hospital statistics & numerical data, Fecal Impaction etiology, Fecal Impaction surgery, Female, Humans, Incidence, Intestinal Perforation etiology, Intestinal Perforation surgery, Male, Middle Aged, Retrospective Studies, Risk Factors, Time Factors, Young Adult, Appendectomy statistics & numerical data, Appendicitis surgery, Fecal Impaction epidemiology, Intestinal Perforation epidemiology, Time-to-Treatment statistics & numerical data
- Abstract
Background: Numerous factors contribute to advanced disease or increased complications in patients with acute appendicitis (AA). This study aimed to identify risk factors associated with AA perforation, including the effect of system time (ST) delay, after controlling for patient time (PT) delay. In this study, PT was controlled (to less than or equal to 24 h) to better understand the effect of ST delay on AA perforation., Methods: Medical records of patients who underwent surgery for AA at a tertiary referral hospital from October 2009 through September 2013 were reviewed. Data collected included demographics, body mass index, presence of fecalith, PT (i.e., duration of time from symptom onset to arrival in emergency department), and ST (i.e., duration of time from arrival in emergency department to operating room). AA was classified as simple (acute, nonperforated) versus advanced (gangrenous, perforated)., Results: Seven hundred forty-seven patients underwent surgery for AA. After excluding patients with PT > 24 h, 445 patients fit the study criteria, of which 358 patients with simple AA and 87 patients with advanced disease. Advanced appendicitis patients were older and had higher body mass index, longer PT, higher WBC, and higher incidence of fecaliths. Both groups had similar ST. Risk factors for advanced appendicitis after multiple regression analysis are age >50 y old, WBC >15,000, the presence of fecaliths, and PT delay >12 h., Conclusions: Once PT delay was limited to ≤24 h, the ST delay of >12 h did not adversely affect the incidence of advanced AA. Age >50 y, WBC >15,000, PT delay >12 h, and the presence of fecaliths were identified as risk factors associated with advanced AA., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
17. Cannabis use in the young and stercoral perforation.
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Singh HK, Young T, Srinivasaiah N, and Marcelle M
- Subjects
- Adult, Colonic Diseases diagnostic imaging, Colonic Diseases surgery, Diagnosis, Differential, Fecal Impaction diagnostic imaging, Fecal Impaction surgery, Humans, Intestinal Perforation diagnostic imaging, Intestinal Perforation surgery, Male, Pneumoperitoneum diagnostic imaging, Pneumoperitoneum surgery, Tomography, X-Ray Computed, Colonic Diseases chemically induced, Fecal Impaction chemically induced, Intestinal Perforation chemically induced, Marijuana Smoking adverse effects, Pneumoperitoneum chemically induced
- Published
- 2019
- Full Text
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18. Unwell Adolescent Patient Presenting to the Emergency Department with Distended Abdomen.
- Author
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Keohane D, Syed AZ, and Kavanagh EG
- Subjects
- Abdomen, Acute etiology, Adolescent, Decompression, Surgical, Fecal Impaction surgery, Humans, Intra-Abdominal Hypertension surgery, Male, Respiratory Distress Syndrome etiology, Fecal Impaction complications, Intra-Abdominal Hypertension etiology, Multiple Organ Failure etiology
- Published
- 2019
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19. Association of Intraoperative Findings With Outcomes and Resource Use in Children With Complicated Appendicitis.
- Author
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Anandalwar SP, Cameron DB, Graham DA, Melvin P, Dunlap JL, Kashtan M, Hall M, Saito JM, Barnhart DC, Kenney BD, and Rangel SJ
- Subjects
- Abdominal Abscess epidemiology, Abdominal Abscess surgery, Adolescent, Appendectomy, Appendicitis epidemiology, Child, Child, Preschool, Cohort Studies, Databases, Factual, Exudates and Transudates, Fecal Impaction epidemiology, Fecal Impaction surgery, Female, Humans, Male, Retrospective Studies, United States epidemiology, Appendicitis surgery, Hospital Costs statistics & numerical data, Length of Stay statistics & numerical data, Patient Readmission statistics & numerical data, Severity of Illness Index, Surgical Wound Infection epidemiology
- Abstract
Importance: The influence of disease severity on outcomes and use of health care resources in children with complicated appendicitis is poorly characterized. Adjustment for variation in disease severity may have implications for ensuring fair reimbursement and comparative performance reporting among hospitals., Objective: To examine the association of intraoperative findings as a measure of disease severity with complication rates and resource use in children with complicated appendicitis., Design: This retrospective cohort study used clinical data from the American College of Surgeons National Surgical Quality Improvement Program pediatric appendectomy pilot database (NSQIP-P database) and cost data from the Pediatric Health Information System database. Twenty-two children's hospitals participated in the NSQIP Pediatric Appendectomy Collaborative Pilot Project. Patients aged 3 to 18 years with complicated appendicitis who underwent an appendectomy from January 1, 2013, through December 31, 2014, were included in the study. Appendicitis was categorized in the NSQIP-P database as complicated if any of the following 4 intraoperative findings occurred in the operative report: visible hole, fibropurulent exudate in more than 2 quadrants, abscess, or extraluminal fecalith. Data were analyzed from January 1, 2013, through December 31, 2014., Main Outcomes and Measures: Thirty-day postoperative adverse event rate, revisit rate, hospital cost, and length of stay. Multivariable regression was used to estimate event rates and outcomes for all observed combinations of intraoperative findings, with adjusting for patient characteristics and clustering within hospitals., Results: A total of 1333 patients (58.7% boys; median age, 10 years; interquartile range, 7-12 years) were included; multiple intraoperative findings of complicated appendicitis were reported in 589 (44.2%). Compared with single findings, the presence of multiple findings was associated with higher rates of surgical site infection (odds ratio, 1.40; 95% CI, 0.95-2.06; P = .09), higher revisit rates (odds ratio, 1.60; 95% CI, 1.15-2.21; P = .005), longer length of stay (rate ratio, 1.45; 95% CI, 1.36-1.55; P < .001), and higher hospital cost (rate ratio, 1.35; 95% CI, 1.19-1.53; P < .001). Significant differences were found among different combinations of intraoperative findings for all outcomes, including a 3.6-fold difference in rates of surgical site infection (range, 7.5% for fecalith alone to 27.2% for all 4 findings; P = .002), a 2.6-fold difference in revisit rates (range, 8.9% for exudate alone to 22.9% for all 4 findings; P = .001), a 2.2-fold difference in length of stay (range, 4.0 days for exudate alone to 8.9 days for all 4 findings; P < .001), and a 2.4-fold difference in mean cumulative cost (range, $13 296 for exudate alone to $32 282 for all 4 findings; P < .001)., Conclusions and Relevance: More severe presentations of complicated appendicitis are associated with worse outcomes and greater resource use. Severity adjustment may be needed to ensure fair reimbursement and comparative performance reporting, particularly at hospitals treating underserved populations where more severe presentations are common.
- Published
- 2018
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20. Colonoscopic removal of a giant appendiceal faecolith without appendectomy for acute appendicitis - a video vignette.
- Author
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Hsu CW
- Subjects
- Acute Disease, Appendicitis etiology, Fecal Impaction complications, Humans, Male, Middle Aged, Appendicitis surgery, Colonoscopy methods, Fecal Impaction surgery
- Published
- 2018
- Full Text
- View/download PDF
21. What Is Your Diagnosis?
- Author
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Tyma JF, Balducci JJ, and Beasley ELM
- Subjects
- Animals, Colic etiology, Colonic Diseases complications, Colonic Diseases diagnostic imaging, Colonic Diseases surgery, Diagnosis, Differential, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Fecal Impaction surgery, Horses, Humans, Laparoscopy veterinary, Male, Radiography veterinary, Colic veterinary, Colonic Diseases veterinary, Fecal Impaction veterinary, Horse Diseases diagnostic imaging
- Published
- 2018
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22. Rare but life-threatening complication of fecalith.
- Author
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Mou D, Atkinson R, Valero M, and Melnitchouk N
- Subjects
- Abdominal Pain etiology, Aged, Colectomy, Colonic Diseases pathology, Colonic Diseases surgery, Computed Tomography Angiography, Fecal Impaction pathology, Fecal Impaction surgery, Female, Fluid Therapy, Humans, Ileostomy, Laparotomy, Nausea, Necrosis pathology, Necrosis surgery, Peritoneal Lavage, Treatment Outcome, Vomiting, Colonic Diseases diagnostic imaging, Colonic Diseases etiology, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Necrosis diagnostic imaging, Necrosis etiology
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2018
- Full Text
- View/download PDF
23. Large bowel obstruction in a 27-year-old woman caused by a sigmoid faecal bolus.
- Author
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Smith RAJ, Abdalkoddus M, and Bethune R
- Subjects
- Acute Disease, Adult, Colon, Sigmoid surgery, Decompression, Surgical, Delayed Diagnosis, Fecal Impaction surgery, Female, Humans, Intestinal Obstruction surgery, Laparotomy, Sigmoid Diseases surgery, Tomography, X-Ray Computed, Ultrasonography, Colon, Sigmoid diagnostic imaging, Fecal Impaction diagnostic imaging, Intestinal Obstruction diagnostic imaging, Sigmoid Diseases diagnosis
- Abstract
A 27-year-old woman presented to the emergency department with a 24-hour history of severe left iliac fossa pain associated with vomiting. She reported a history of ovarian cysts and was provisionally diagnosed with a ruptured ovarian cyst and admitted under the obstetrics and gynaecology team for further investigation. 24 hours later, she became haemodynamically unstable with increasing abdominal distention and developed a metabolic acidosis. A CT scan revealed large bowel obstruction (LBO) secondary to a faecal bolus in the sigmoid colon with appearances suggestive of adult-onset Hirschsprung's disease. She underwent an emergency laparotomy and decompressive transverse colotomy and was admitted to the intensive care unit overnight. After discharge, she presented again with small bowel obstruction (SBO) which resolved with conservative management. A follow-up colonoscopy and biopsies showed no anatomical abnormalities to account for the LBO and were inconclusive for Hirschsprung's disease., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2018
- Full Text
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24. Giant granadilla's seeds phytobezoar rectal impactation: a very unusual case of intestinal obstruction.
- Author
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Alexandre AR, Costa LD, and Raimundo P
- Subjects
- Aged, Bezoars diagnostic imaging, Bezoars surgery, Fecal Impaction surgery, Humans, Intestinal Perforation etiology, Intestinal Perforation surgery, Male, Radiography, Sigmoidoscopy, Tomography, X-Ray Computed, Bezoars complications, Fecal Impaction diagnostic imaging, Passiflora, Rectum diagnostic imaging, Seeds
- Abstract
A 78-year-old Caucasian man presented to the emergency department with bloody diarrhoea, diffuse abdominal pain and fever with 1-week duration. He had just returned from Angola where he had been treated for a presumed Clostridium difficile infection without improvement. He had no relevant medical or familiar history except for hypertension and prostate benign hyperplasia. He was drowsy, feverish and eupnoeic. His oxygen saturation on pulse oximetry was 92%, blood pressure was 173/99 mm Hg and pulse rate 100 beats per minute. Except for a distended, silent and painful abdomen, particularly on lower quadrants, the rest of the examination was unremarkable. A CT showed a mesh-like mass inside the rectum conditioning colonic obstruction and distention. This turned to be a giant granadilla's seeds phytobezoar and was removed endoscopically. Five days later, the patient had a colonic perforation requiring total colectomy. He made a full recovery after rehabilitation for 3 months., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2018
- Full Text
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25. [Faecal impaction in elderly patients is a potential severe condition].
- Author
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Nissen SK, Stenberg MR, and Ryg J
- Subjects
- Aged, 80 and over, Analgesics, Opioid administration & dosage, Analgesics, Opioid therapeutic use, Buprenorphine administration & dosage, Buprenorphine therapeutic use, Critical Illness, Fatal Outcome, Fecal Impaction diagnostic imaging, Fecal Impaction drug therapy, Fecal Impaction surgery, Humans, Laxatives therapeutic use, Male, Tomography, X-Ray Computed, Analgesics, Opioid adverse effects, Buprenorphine adverse effects, Fecal Impaction chemically induced
- Abstract
This case report presents an old hemiparetic male admitted to hospital from nursing home due to dark-coloured emesis. Transdermal buprenorphine 5 mcg/h had been instigated without laxatives in the preceding month. Upon arrival, an enlarged tense abdomen was found. A CT-scan dem-on-strated a 19 cm wide faecal colon impaction. Limited effect of enemas and endoscopic disimpaction resulted in surgery. The patient died shortly after discharge. The case stresses the prevention of constipation when using opioids; in particular in immobilized patients.
- Published
- 2017
26. Laparoscopic surgery assisted by colonoscopy for a submucosal cecal fecalith presenting as acute appendicitis: A case report.
- Author
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Ruan XJ, Ye BL, Zheng ZH, Zhou HH, Zheng XF, and Zhou ZX
- Subjects
- Aged, Diagnosis, Differential, Diagnostic Errors, Female, Humans, Intestinal Mucosa surgery, Appendicitis diagnosis, Cecal Diseases surgery, Colonoscopy methods, Fecal Impaction surgery, Laparoscopy methods
- Abstract
Rationale: A cecal submucosal fecalith is extremely rare and is likely to be misdiagnosed as appendicitis with an incarcerated fecalith., Patient Concerns: This review presents the case of a female patient complaining of recurrent abdominal pain in the right lower quadrant, similar to the clinical symptoms of appendicitis. Physical examination revealed an abdominal tenderness in the right lower quadrant without rebound tenderness or muscular tension. An ultrasound examination found a mass located in the right lower abdomen. Computed tomography showed a high-density shadow in the cecal cavity., Diagnoses: A fecalith was detected in the submucosal cecal wall. The postoperative pathologic examination showed that the fecalith was located in the submucosa., Interventions: A partial cecal excision was performed under laparoscopic surgery assisted by colonoscopy., Outcomes: The patient was discharged 1 week after surgery without postoperative complications., Lessons: Fecaliths should be considered in the differential diagnosis of submucosal occupying lesions of the cecum., (Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2017
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27. Stercoral perforation of the colon in a heroin addict.
- Author
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Brown CD, Maxwell F, French P, and Nicholson G
- Subjects
- Adult, Colon, Sigmoid diagnostic imaging, Fecal Impaction diagnostic imaging, Female, Humans, Intestinal Perforation diagnostic imaging, Peritonitis etiology, Tomography, X-Ray Computed, Treatment Outcome, Colon, Sigmoid surgery, Fecal Impaction surgery, Heroin Dependence complications, Intestinal Perforation surgery
- Abstract
A 27-year-old female heroin addict presented with a peritonitic and distended abdomen. Her medical history included depression and a 3-year history of heroin abuse with attendant constipation. CT scan showed free intraperitoneal gas, massive faecal distension of the rectum and sigmoid colon and likely bowel necrosis. She underwent an emergency Hartmann's procedure for perforation of the sigmoid colon. Pathology identified two areas of stercoral ulceration, one of them being the area of perforation. Postoperatively, the patient developed a deep vein thrombosis and is now on anticoagulant therapy. She was discharged 4 weeks after admission. The patient has been reviewed at follow-up clinic by the surgical team and specialist stoma nurses. She is coping well with good stoma function. We will perform a colonoscopy to identify any further areas of stercoral ulceration but there are no plans for further surgery at present., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
- Full Text
- View/download PDF
28. Stercoral perforation of the rectum with faecal peritonitis and pneumatosis coli: A case Report.
- Author
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Kanwal D, Attia KME, Fam MNA, Khalil SMF, and Alblooshi AM
- Subjects
- Aged, Colostomy, Contrast Media, Diagnosis, Differential, Fecal Impaction surgery, Female, Gastrostomy, Humans, Intestinal Perforation surgery, Peritonitis surgery, Rectum surgery, Tomography, X-Ray Computed, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Intestinal Perforation diagnostic imaging, Intestinal Perforation etiology, Peritonitis diagnostic imaging, Peritonitis etiology, Rectum diagnostic imaging
- Abstract
Colonic perforation due to impacted faeces or faecaloma is a relatively uncommon presentation with grave prognosis. If left untreated, it can be life threatening due to complications like faecal peritonitis. Till date, fewer than 150 cases have been reported mostly in the English surgical literature describing constipation as the most common underlying etiology. Involvement of rectum is rare with very limited data published in this context. We present a case of stercoral perforation involving the rectum with associated faecal peritonitis and pneumatosis coli.
- Published
- 2017
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29. A giant abdominal mass in a 23-year-old woman.
- Author
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Cherbanyk F and Martinet O
- Subjects
- Adult, Fecal Impaction surgery, Female, Humans, Fecal Impaction diagnostic imaging
- Published
- 2017
- Full Text
- View/download PDF
30. Threatening Fecal Impaction.
- Author
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Hernu R, Cour M, Wallet F, and Argaud L
- Subjects
- Abdominal Pain etiology, Adolescent, Albuterol pharmacology, Albuterol therapeutic use, Bronchodilator Agents pharmacology, Bronchodilator Agents therapeutic use, Colon abnormalities, Colon physiopathology, Colon surgery, Edema etiology, Emergency Service, Hospital organization & administration, Fecal Impaction surgery, Humans, Male, Tomography, X-Ray Computed methods, Fecal Impaction complications, Fecal Impaction diagnosis
- Published
- 2017
- Full Text
- View/download PDF
31. A Fecalith of the Colon Simulating a Submucosal Neoplasm.
- Author
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Liu L, Lu X, and Qiu X
- Subjects
- Adult, Colonoscopy, Diagnosis, Differential, Endoscopic Mucosal Resection, Fecal Impaction surgery, Humans, Male, Tomography, X-Ray Computed, Colon surgery, Colonic Neoplasms diagnosis, Fecal Impaction diagnosis
- Published
- 2016
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32. [Fecaloma, a rare condition with severe constipation in a patient in chronic hemodialysis].
- Author
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Bc D and Tougaard BG
- Subjects
- Fecal Impaction surgery, Fecal Impaction therapy, Female, Humans, Middle Aged, Renal Dialysis, Sigmoid Diseases surgery, Sigmoid Diseases therapy, Tomography, X-Ray Computed, Constipation etiology, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Sigmoid Diseases complications, Sigmoid Diseases diagnostic imaging
- Published
- 2016
33. Acute typhlitis caused by a caecal faecolith.
- Author
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Abdel-Kader S, Al-Salam S, and Abu-Zidan FM
- Subjects
- Acute Disease, Adult, Fecal Impaction surgery, Humans, Male, Typhlitis surgery, Fecal Impaction complications, Typhlitis etiology
- Abstract
Isolated acute typhlitis caused by a caecal faecolith is extremely rare. Hereby we report such a case. A 30-year-old man presented clinically as acute appendicitis. During open surgery, an inflamed caecal mass was found. A limited colectomy including the mass and grossly health margins was performed. Histopathological examination confirmed that acute typhlitis was caused by an impacted caecal faecolith. The appendix was normal. Faecolith is an extremely rare cause of acute inflammation of the caecum presenting as a mass which is usually treated by limited right hemicolectomy., (Copyright © 2016 Arab Journal of Gastroenterology. Published by Elsevier B.V. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
34. [A giant fecalith complicated by acute urinary retention, hydronephrosis and acute obstructive pyelonephritis].
- Author
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Davidov MI
- Subjects
- Acute Disease, Adult, Humans, Male, Fecal Impaction complications, Fecal Impaction diagnostic imaging, Fecal Impaction surgery, Hydronephrosis diagnostic imaging, Hydronephrosis etiology, Hydronephrosis surgery, Pyelonephritis diagnostic imaging, Pyelonephritis etiology, Pyelonephritis surgery, Urinary Retention diagnostic imaging, Urinary Retention etiology, Urinary Retention surgery
- Abstract
The article reports a rare case of a 30-year-old man with Hirschsprung's disease, who developed a giant fecalith in the rectum and sigmoid (weight 3.5 kg, the largest diameter 20 cm). The fecalith impaired urine flow by compressing urinary tract, thereby causing acute urinary retention and right-sided hydronephrosis with acute obstructive pyelonephritis. Removing fecalith resulted in the patient recovery and normal functioning of genitourinary system.
- Published
- 2016
35. FECALITH IN THE ILEUM CAUSING INTESTINAL OBSTRUCTION.
- Author
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Qurrat-ul-Ain, Azhar SA, Baloch S, Khan SA, and Salim A
- Subjects
- Aged, Fecal Impaction surgery, Female, Humans, Ileum surgery, Intestinal Obstruction surgery, Fecal Impaction complications, Intestinal Obstruction etiology
- Abstract
Small bowel obstruction is one of the common conditions presenting in surgical wards, however fecalith is one of the rare causes of bowel obstruction. We present here a case of 65 years old lady, who presented with sub-acute intestinal obstruction. In spite of the initial diagnosis being sigmoid volvulus, exploratory laparotomy revealed a focolith in ileum which was retrieved through an enterotomy and primary closure was done. The patient recovered uneventfully. Thus emphasizing the need of through history and workup which steer us to the correct diagnosis.
- Published
- 2016
36. Ileocolonic anastomosis fecalith impaction in a patient with Crohn's disease: needle-knife stricturotomy and stone retrieval.
- Author
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Chidi V, Oberc A, and Shen B
- Subjects
- Aged, Anastomosis, Surgical adverse effects, Colonoscopy, Female, Humans, Intestinal Mucosa surgery, Colon surgery, Crohn Disease surgery, Fecal Impaction etiology, Fecal Impaction surgery, Ileum surgery
- Published
- 2015
- Full Text
- View/download PDF
37. Video of the month: crowbar endoscopic enucleation of a giant appendicolith.
- Author
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Curcio G, Granata A, Ligresti D, Orlando R, Tarantino I, Barresi L, and Traina M
- Subjects
- Aged, Appendix, Cecal Diseases diagnosis, Fecal Impaction diagnosis, Humans, Male, Cecal Diseases surgery, Colonoscopy methods, Fecal Impaction surgery
- Published
- 2015
- Full Text
- View/download PDF
38. Outcome of Surgical and Medical Management of Cecal Impaction in 150 Horses (1991-2011).
- Author
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Aitken MR, Southwood LL, Ross BM, and Ross MW
- Subjects
- Anastomosis, Surgical veterinary, Animals, Cecal Diseases surgery, Cecal Diseases therapy, Fecal Impaction mortality, Fecal Impaction surgery, Fecal Impaction therapy, Female, Horse Diseases surgery, Horses, Intestine, Small surgery, Male, Pennsylvania epidemiology, Retrospective Studies, Survival Analysis, Treatment Outcome, Cecal Diseases veterinary, Fecal Impaction veterinary, Horse Diseases therapy
- Abstract
Objective: To evaluate short- and long-term outcome after medical and surgical management of horses with cecal impaction and to determine reasons for death or euthanasia., Study Design: Retrospective case series., Animals: Horses (n = 150)., Methods: Data collected from medical records (1991-2011) of horses with a diagnosis of cecal impaction, included signalment, history of recent disease/surgical procedure, admission data, management (medical, typhlotomy alone, jejunocolostomy), complications, and outcome. Short-term outcome (alive or dead at discharge) and long-term outcome (alive or dead at ≥1 year) were determined by telephone interview. Data were analyzed using a χ(2) or Fisher's exact test. Level of significance was P < .05., Results: Of 150 horses hospitalized with a diagnosis of cecal impaction, 102 (68%) had a history of recent disease or a surgical procedure. Thirty-eight horses (25%) had cecal perforation at admission and 3 horses (2%) were euthanatized without treatment. Of 109 horses treated, 59 (54%) were managed medically and 50 (46%) surgically (typhlotomy [26]; jejunocolostomy [24]). The proportion of horses alive at hospital discharge was significantly lower for horses managed medically (61%) compared with surgically (82%; P = .02) but there was no difference between horses managed with typhlotomy alone (77%) or with jejunocolostomy (88%; P = .47). There were 57% of horses managed medically alive at 1 year. There was a similar proportion of horses alive at 1 year after typhlotomy alone (73%) and jejunocolostomy (70%; P = .86)., Conclusions: Compared to the recent reports, the proportion of horses alive at hospital discharge was lower for both medically and surgically managed horses with cecal impaction. There was decreased survival for horses treated medically than those treated surgically; however, no significant difference was seen in survival between horses managed with typhlotomy alone versus jejunocolostomy., (© Copyright 2014 by The American College of Veterinary Surgeons.)
- Published
- 2015
- Full Text
- View/download PDF
39. Submucosal fecalith in the ileocecal valve.
- Author
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Zhao H, Li Y, and Cao D
- Subjects
- Adult, Colonoscopy, Dissection, Endosonography, Humans, Ileocecal Valve, Intestinal Mucosa surgery, Male, Tomography, X-Ray Computed, Fecal Impaction diagnosis, Fecal Impaction surgery
- Published
- 2014
- Full Text
- View/download PDF
40. Submucosal tumor-like appendiceal intussusception as a result of fecalith.
- Author
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Meguro Y, Koide A, and Tabuchi T
- Subjects
- Aged, Colonoscopy, Contrast Media, Diagnosis, Differential, Fecal Impaction diagnosis, Humans, Intussusception diagnosis, Laparoscopy, Male, Tomography, X-Ray Computed, Appendix, Fecal Impaction complications, Fecal Impaction surgery, Intussusception etiology, Intussusception surgery
- Published
- 2014
- Full Text
- View/download PDF
41. Drainage of periappendiceal abscess and removal of free fecalith--extraperitoneal approach.
- Author
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Chang CR and Cheng CY
- Subjects
- Abdominal Abscess diagnostic imaging, Adolescent, Aged, Appendectomy, Appendicitis diagnostic imaging, Diagnosis, Differential, Drainage, Fecal Impaction diagnostic imaging, Female, Humans, Male, Tomography, X-Ray Computed, Abdominal Abscess surgery, Appendicitis surgery, Fecal Impaction surgery
- Abstract
Treatment of complicated acute appendicitis is controversial. The dilemma is further complicated by presence of free fecalith in a well-circumscribed abscess, which has been repeatedly demonstrated to be a major predicting factor of treatment failure of nonoperative treatment of acute appendicitis complicated with appendiceal abscess. If left behind after drainage of the abscess, further operations for removal of retained fecalith or recurrence of abscess might be required. However, little had been stressed over the significance of removal of the free fecalith when it was first encountered. We report our experience of drainage of appendiceal abscess and removal of free fecalith by taking an extraperitoneal approach. Both of our cases made a smooth recovery without any complication or recurrence after a 2-year follow-up. Treatment with this approach avoids many of the complications associated with formal laparotomy. Unlike image-guided drainage or laparoscopic drainage, this procedure is relatively simple and straightforward and can be performed in any level of hospital, including private practitioners and in less well-developed areas and countries. With proper case selection, we recommend this approach as one of the alternatives in the treatment of late-presenting appendiceal abscess with free fecalith.
- Published
- 2014
- Full Text
- View/download PDF
42. Atypical indications for transanal endoscopic microsurgery to avoid major surgery.
- Author
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Serra-Aracil X, Mora-Lopez L, Alcantara-Moral M, Corredera-Cantarin C, Gomez-Diaz C, and Navarro-Soto S
- Subjects
- Anal Canal, Condylomata Acuminata surgery, Constriction, Pathologic surgery, Debridement, Drainage, Fecal Impaction surgery, Gastrointestinal Stromal Tumors surgery, Intestinal Perforation surgery, Microsurgery, Rectal Fistula surgery, Rectal Neoplasms surgery, Rectal Prolapse surgery, Urethra surgery, Urinary Fistula surgery, Abscess surgery, Endoscopy, Gastrointestinal, Natural Orifice Endoscopic Surgery, Pelvis, Rectal Diseases surgery
- Abstract
Background: Transanal endoscopic microsurgery (TEM) was originally designed for the removal of rectal tumors, principally incipient adenomas, and adenocarcinomas up to 20 cm from the anal verge. However, with the evolution of the technique and the increase in surgeons' experience, new indications have emerged and TEM may now be used in place of other surgical procedures which are associated with higher morbidity. The aim of our study was to evaluate our group's use of TEM or transanal endoscopic operations (TEO) for conditions other than rectal tumors., Methods: An observational study of TEM (using Wolf equipment) or TEO (using Storz equipment) for indications other than excision of rectal tumors was conducted from June 2004 to July 2012., Results: Four hundred twenty-four procedures were performed using TEM/TEO: removal of adenocarcinomas in 148 (34.9 %) patients, adenomas in 236 (55.7 %), post-polypectomy excision in 12 (2.8 %), removal of neuroendocrine tumors in 8 (1.9 %), and atypical indications in 20 (4.7 %). Atypical indications were pelvic abscess (3), benign rectal stenoses (2), rectourethral fistula after prostatectomy (3), gastrointestinal stromal tumor (3), endorectal condylomata acuminata (1), rectal prolapse (2), extraction of impacted fecaloma in the rectosigmoid junction (1), repair of traumatic and iatrogenic perforation of the rectum (2), and presacral tumor (3)., Conclusions: The use of TEM/TEO in atypical indications may benefit patients by avoiding surgical procedures associated with greater morbidity.
- Published
- 2014
- Full Text
- View/download PDF
43. Constipation associated with brumation? Intestinal obstruction caused by a fecalith in a wild red diamond rattlesnake (Crotalus ruber).
- Author
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Corbit AG, Person C, and Hayes WK
- Subjects
- Animals, Constipation pathology, Fecal Impaction pathology, Fecal Impaction surgery, Female, Animals, Wild, Constipation veterinary, Crotalus, Fecal Impaction veterinary
- Abstract
This report describes the fecalith-induced intestinal obstruction of a free-ranging red diamond rattlesnake (Crotalus ruber) and the snake's subsequent history following surgical removal of the fecalith. The captured snake exhibited an abnormally distended abdomen and an extremely hard mass, detected via palpation, near its vent. Coeliotomy yielded a 2.5-cm, 5-g fecalith from the large intestine. Microscopic dissection of the fecalith revealed no evidence of gastrointestinal parasitic worms. Subsequently, we implanted a radio-transmitter that allowed us to track the snake's movements for 7 months (until the radio signal vanished), indicating normal behaviour, complete recovery and good health apart from the obstruction. This observation suggests that fecalith development and intestinal obstruction represent potential risks of long-term faecal retention, an unusual physiological trait well documented among rattlesnakes and other stout, heavy-bodied terrestrial viperid snakes. Dehydration and decreased gut motility associated with brumation (≈hibernation) may predispose temperate snakes to fecalith formation. Regional drought and a small mammal diet with indigestible hairs might have also promoted fecalith formation in this specimen., (© 2013 Blackwell Verlag GmbH.)
- Published
- 2014
- Full Text
- View/download PDF
44. Clinical signs, treatment, and prognosis for horses with impaction of the cranial aspect of the base of the cecum: 7 cases (2000-2010).
- Author
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Sherlock CE and Eggleston RB
- Subjects
- Animals, Fecal Impaction surgery, Female, Horse Diseases surgery, Horses, Male, Cecum pathology, Fecal Impaction veterinary, Horse Diseases pathology
- Abstract
Objective: To determine the clinical signs, treatment, and prognosis for horses with impaction of the cranial aspect of the base of the cecum (cecal cupula)., Design: Retrospective observational case series., Animals: 7 horses with colic attributed to cecal cupula impaction., Procedures: Medical records were reviewed and horses that underwent exploratory celiotomy from 2000 through 2010 were identified. Horses with cecal cupula impaction and without other abdominal problems to which colic could be attributed were selected for inclusion in the study. Information regarding history, clinical findings, diagnostic testing, surgical findings and treatments, and treatments and complications after surgery was recorded. Rate of survival of horses to discharge from the hospital was determined. Long-term follow-up information was obtained with telephone questionnaires., Results: Cecal cupula impaction without other cecal abnormalities was identified in 7 horses during exploratory celiotomy. Although clinical signs varied, horses typically had mild signs of colic and nondiagnostic rectal examination findings but were in systemically stable conditions at the time of the initial evaluation. Typhlotomies were performed and impactions were resolved by means of lavage and evacuation. All horses survived to discharge from the hospital and lived ≥ 2 years after surgery., Conclusions and Clinical Relevance: Results of this study suggested cecal cupula impaction was a novel type of cecal impaction that was uncommon. Impactions did not involve the cecal body or apex and hypertrophy of the cecal wall was not grossly detected. Impactions were successfully treated with typhlotomy, lavage, and evacuation. Horses had a good prognosis after surgical treatment.
- Published
- 2013
- Full Text
- View/download PDF
45. Rectal perforation by impacted fecaloma--a new mechanism proposed.
- Author
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Narang A, Mittal S, Garg P, Aggarwal S, Singh J, Kaushik K, and Verma S
- Subjects
- Aged, Contrast Media, Diagnosis, Differential, Diagnostic Imaging, Fecal Impaction diagnosis, Fecal Impaction surgery, Female, Humans, Intestinal Perforation diagnosis, Intestinal Perforation surgery, Fecal Impaction complications, Intestinal Perforation etiology, Rectum injuries
- Published
- 2013
- Full Text
- View/download PDF
46. Image of the month. Perforated small-bowel diverticulum with calcified fecalith.
- Author
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Lassaletta AD, Fike FB, and Sheth KR
- Subjects
- Diverticulum complications, Diverticulum surgery, Fecal Impaction complications, Fecal Impaction surgery, Humans, Intestinal Perforation etiology, Intestinal Perforation surgery, Jejunal Diseases complications, Jejunal Diseases surgery, Male, Middle Aged, Tomography, X-Ray Computed, Diverticulum diagnostic imaging, Fecal Impaction diagnostic imaging, Intestinal Perforation diagnostic imaging, Jejunal Diseases diagnostic imaging
- Published
- 2013
- Full Text
- View/download PDF
47. Spiral colon impaction in juvenile alpacas: 12 cases (2006-2010).
- Author
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Hart JC, Burton AJ, Pinn TL, Fubini SL, and Dawson DR
- Subjects
- Animals, Colonic Diseases pathology, Colonic Diseases surgery, Fecal Impaction pathology, Fecal Impaction surgery, Female, Male, Retrospective Studies, Survival Analysis, Camelids, New World, Colonic Diseases veterinary, Fecal Impaction veterinary
- Abstract
Objective: To describe clinical signs and treatment outcomes for juvenile alpacas with spiral colon impaction (SCI)., Design: Retrospective case series. Animals-12 juvenile (< 6 months old) camelids with SCI., Procedures: Crias with SCI were identified by searching the medical records database of the Cornell University Equine and Farm Animal Hospital. A keyword-based search method was used. Inclusion required confirmation of SCI on the basis of surgical or necropsy findings. History, signalment, examination findings, diagnostic test results, medical treatments, and surgical reports as well as short- and long-term outcomes were reviewed. Peritoneal fluid parameters were compared with those of age-matched comparison crias in which SCI was suspected but ruled out at necropsy or exploratory celiotomy., Results: 12 crias with confirmed SCI were identified. Common clinical signs included lethargy and diarrhea. Abdominal distention was observed in 9 crias. In 3 crias, a mass in the region of the spiral colon was palpated. Seven crias underwent peritoneal fluid analysis; compared with age-matched comparison crias, SCI-affected crias had higher peritoneal fluid nucleated cell counts and nucleated cell count-to-total protein concentration ratios. A ventral midline celiotomy was performed in 9 crias; 7 underwent an enterotomy, and 2 underwent transmural infusion of saline (0.9% NaCl) solution with manual breakdown of ingesta; 3 of these crias survived for at least 6 months., Conclusions and Clinical Relevance: Crias with SCI that were not resolved by medical management had a poor prognosis. During celiotomy, transmural infusion of saline solution with manual breakdown of ingesta provided a less invasive alternative to enterotomy.
- Published
- 2013
- Full Text
- View/download PDF
48. Stapled transanal rectal resection with contour transtar for obstructed defecation syndrome: lessons learned after more than 3 years of single-center activity.
- Author
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Masoni L, Mari FS, Favi F, Gasparrini M, Cosenza UM, Pindozzi F, Pancaldi A, and Brescia A
- Subjects
- Anal Canal surgery, Defecation, Defecography methods, Female, Humans, Italy, Male, Manometry methods, Middle Aged, Patient Satisfaction, Recovery of Function, Retrospective Studies, Surgical Instruments, Surgical Stapling instrumentation, Surgical Stapling methods, Treatment Outcome, Constipation complications, Constipation diagnosis, Constipation physiopathology, Digestive System Surgical Procedures adverse effects, Digestive System Surgical Procedures instrumentation, Digestive System Surgical Procedures methods, Fecal Impaction complications, Fecal Impaction diagnosis, Fecal Impaction physiopathology, Fecal Impaction surgery, Postoperative Complications physiopathology, Rectocele etiology, Rectocele physiopathology, Rectocele surgery, Rectum physiopathology, Rectum surgery
- Abstract
Background: Obstructed defecation syndrome is a widespread and disabling disease., Objective: We aim to evaluate the safety and efficacy of stapled transanal rectal resection performed with a new dedicated curved device in the treatment of obstructed defecation syndrome., Design: A retrospective review of 187 stapled transanal rectal resections performed from June 2007 to February 2011 was conducted., Settings: The entire study was conducted at a university hospital., Patients: : All the patients with symptomatic obstructed defecation syndrome and the presence of a rectocele and/or a rectorectal or rectoanal intussusception, in the absence of sphincter contractile deficiency, were included in the treatment protocol., Interventions: All procedures were performed with the use of the Contour Transtar device. We analyzed the functional results of this technique, the incidence and features of the surgical and functional complications, and ways to prevent or treat them., Main Outcome Measures: Constipation was graded by using the Agachan-Wexner constipation score; use of aids to defecate and patient satisfaction were assessed preoperatively and 6 months after surgery. Intraoperative and postoperative complications were also investigated., Results: The constipation intensity was statistically reduced from the preoperative mean value of 15.8 (± 4.9) to 5.2 (± 3.9) at 6 months after surgery (p < 0.0001). Of the 151 (80.3%) patients who took laxatives and the 49 (26.2%) who used enemas before treatment, only 25 (13.2%; p < 0.0001) and 7 (3.7%; p < 0.0001) continued to do so after surgery. None of the 17 (9.1%) patients who had previously helped themselves with digitations needed to continue this practice. Almost all patients showed a good satisfaction rate (3.87/5) after the procedure., Limitations: Limitations are the short follow-up of 1 year and the design of the study that may introduce potential selection bias., Conclusions: The results of this study show that stapled transanal rectal resection performed with the use of the Contour Transtar is a safe and effective procedure to treat obstructed defecation syndrome.
- Published
- 2013
- Full Text
- View/download PDF
49. The importance of fecaliths in the aetiology of acute appendicitis.
- Author
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Engin O, Muratli A, Ucar AD, Tekin V, Calik B, and Tosun A
- Subjects
- Acute Disease, Adult, Appendicitis surgery, Diagnosis, Differential, Fecal Impaction surgery, Humans, Retrospective Studies, Treatment Outcome, Appendectomy, Appendicitis diagnosis, Appendicitis etiology, Fecal Impaction complications, Fecal Impaction diagnosis
- Abstract
Aim: Fecaliths, lymphoid hyperplasia, parasites, undigested plant residues and foreign bodies are considered as part of the aetiology of acute appendicitis. In our article we discussed about fecaliths, fecalith formation, and its aetiological value., Methods: Patients which have been operated on for acute appendicitis between 2009-2010 are analysed retrospectively., Results: The average age was 29,3. The number of cases with fecalith was 261 (36,1%). Out of these, 19 acute appendicites, 95 phlegmons, and 30 perforations were detected., Conclusions: Intraluminal pathologies probably play a major role in the development of acute appendicitis. Intraluminal pathological findings may also be seen in healthy persons without necessarily pointing to acute appendicitis. Disease progresses from intraluminal fecalith with no inflammation to perforation from the beginning. There are many explanations regarding the formation of fecaliths. Diagnosis of the fecalith may be decided with ultrasonography, computed tomography and magnetic resonance imaging techniques. In case of preoperatively demonstrated intraluminal fecalith through ultrasonographic examination with clinical symptoms of acute appendicitis, early appendectomy must be performed in our opinion. Early appendectomy lowers morbidity and mortality rates., (Celsius.)
- Published
- 2012
50. Cytomegalovirus colitis presenting as a polypoid nodular lesion.
- Author
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AbdullGaffar B, Raman LG, AlAbsi N, and Latif A
- Subjects
- Aged, 80 and over, Colitis surgery, Colitis virology, Colon, Sigmoid pathology, Colon, Sigmoid surgery, Cytomegalovirus Infections surgery, Cytomegalovirus Infections virology, Diagnosis, Differential, Fatal Outcome, Fecal Impaction pathology, Fecal Impaction surgery, Female, Humans, Colitis diagnosis, Colonic Polyps diagnosis, Cytomegalovirus isolation & purification, Cytomegalovirus Infections diagnosis, Precancerous Conditions diagnosis
- Published
- 2012
- Full Text
- View/download PDF
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