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Published on: October 16, 2013
Stercoral colitis: a lethal disease-computed tomographic findings and clinical characteristic
Maxim Saksonov1, Gil N Bachar, Sara Morgenstern
1From the *Department of Diagnostic Imaging, Rabin Medical Center, Petah-Tikva; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; ‡Department of Diagnostic Imaging, Hillel Yaffe Medical Center, Hadera; §Department of Diagnostic Imaging, Asaf Harofe Medical Center, Tzrifin; and ∥Department of Diagnostic Imaging, Sheba Tel Hashomer Medical Center, Ramat-Gan, Israel.
Objective:
The aim of this study was to describe the radiographic findings in stercoral colitis.
Methods:
The computed tomographic scans and abdominal radiographs of 13 patients with surgically and pathologically confirmed stercoral colitis from 4 affiliated hospitals were reviewed by a board-certified abdominal radiologist blinded to the official imaging, surgical, and pathologic findings.
Results:
The median age was 66 years. The patients presented mainly with constipation (100%) and an acute inflammatory process (85%); 5 patients (38%) had frank septic shock. Mortality was 46%. Imaging scans showed that the colon dilated proximally to the impaction site in 6 patients (50%). Other findings included fat stranding (100%), mucosal sloughing (58%), mesenteric hyperemia (58%), and extraluminal gas (17%).
Conclusions:
Computed tomography is an important diagnostic modality for stercoral colitis. The presence of a large fecaloma with distention of the affected colon and wall thickening and pericolonic fat stranding should alert radiologists and surgeons to the presence of this potentially fatal condition.
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