Acute Hydronephrosis owing to A Giant Fecaloma in an Older Patient

Hydroureteronephrosis with acute urinary tract obstruction can lead to serious complications such as obstructive nephropathy or pyelonephritis. We report the first case of hydroureteronephrosis caused by a giant fecaloma in an 83-year-old woman accompanied with chronic constipation in Korea. The patient with a fever presented to the emergency room and was diagnosed with right hydronephrosis. Computed tomography revealed a markedly dilated rectum with a giant fecaloma compressing the right vesicoureteric junction. Hydroureteronephrosis was resolved through manual disimpaction of the fecaloma and simultaneous lavage with rectal tubes, which improved the acute pyelonephritis and renal function. Chronic constipation can lead to giant fecaloma threatening urinary tract patency, especially in older patients with immobility or dehydration. Therefore, clinicians should consider this condition as a rare but possible cause of hydronephrosis in older adult patients with chronic constipation.