Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Ileal Fecaloma Presenting with Small Bowel Obstruction

  • Yoo, Ha Yeong (Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Park, Hye Won (Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Chang, Seong-Hwan (Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Bae, Sun Hwan (Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine)
  • Received : 2015.01.15
  • Accepted : 2015.03.09
  • Published : 2015.09.30
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Abstract

A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.

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References

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