Stercoral Colitis: An Unexpected Presentation in a Young Adolescent

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pediatric Gastroenterology

Background:

• Stercoral colitis is an uncommon inflammatory condition linked to chronic constipation and fecal impaction.
• It typically affects the elderly or immobilized but can occur in pediatric patients.
• Complications include colonic perforation, ischemia, and high mortality rates, exceeding 60% in vulnerable groups.

Observation:

• A case of stercoral colitis in a 14-year-old female presented with diarrhea, abdominal pain, and metabolic acidosis.
• Diagnostic challenges were noted due to initial improvement followed by deterioration.
• Key indicators include vague abdominal symptoms, leukocytosis, elevated inflammatory markers, and metabolic derangements.

Findings:

• Abdominal CT scans are crucial for diagnosing stercoral colitis, revealing colonic distension and wall thickening.
• Treatment involves aggressive bowel disimpaction; surgery or endoscopy is reserved for severe or refractory cases.
• Early recognition is essential for timely intervention and improved patient outcomes.

Implications:

• This case highlights the importance of considering stercoral colitis in pediatric patients with chronic constipation and abdominal symptoms.
• Diagnostic imaging aids in accurate diagnosis and guides therapeutic strategies.
• Timely management can mitigate significant morbidity and mortality associated with this condition.