Giant Fecaloma Causing Large Bowel Obstruction: A Case Report

Fecaloma is an accumulation of hardened impacted stool typically located in the sigmoid colon and rectum [1-3]. The accumulation of fecal matter builds up in the intestine and stagnates, further increasing in size and volume taking on the characteristics of a tumour [4,5]. Symptoms of a fecaloma are commonly nonspecific including chronic constipation, vague abdominal pain after meals, and weight loss [6]. In cases of large fecaloma, patients may feel a palpable hardened mass in their abdomen. Fecalomas have been associated with elderly patients with chronic constipation, psychiatric conditions, Hirschsprung’s disease, and Chagas disease [7]. Fecaloma is diagnosed radiologically through x-rays, barium enema, abdominal ultrasound, or abdominal computed tomography (CT) scans [8]. Most cases are managed conservatively with laxatives and enemas. However, some cases are refractory to conservative management [9], as in this case, requiring surgical intervention for removal of the fecaloma preventing further complications. We report a case of a giant fecaloma causing a complete large bowel obstruction requiring surgical management.