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[Giant fecaliths in habitual constipation]
M Merger1, F Klebl, F X Hierlmeier
1Klinik und Poliklinik für Innere Medizin I, Universität Regensburg.
Deutsche Medizinische Wochenschrift (1946)
|November 26, 1999
Summary
Voluntary withholding of defecation can lead to severe fecal impaction (coprostasis), causing megacolon and megarectum. This condition may present as paradoxical diarrhea, complicating diagnosis and treatment.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Psychosomatic Medicine
Background:
- Chronic constipation in adolescents can lead to severe complications.
- Psychological factors can influence bowel function and contribute to gastrointestinal disorders.
Observation:
- A 17-year-old male presented with fecal incontinence and a large abdominal mass.
- Defecography revealed a massive fecalith causing rectal and colonic dilation (megarectum and megacolon).
- No anatomical or neurological abnormalities were identified.
Findings:
- Manual disimpaction and enemas provided temporary relief.
- Recurrent fecalith formation necessitated repeated interventions.
- The patient was referred for psychosomatic treatment due to non-compliance.
Implications:
- Voluntary defecation withholding can cause severe coprostasis and functional bowel obstruction.
- Paradoxical diarrhea can be a presenting symptom of coprostasis.
- Treatment requires prolonged, multidisciplinary interventions, often involving psychosomatic support.