Fecal impaction causing megarectum-producing colorectal catastrophes. A report of two cases.
OBJECTIVE
Massive fecal impaction leading to surgical catastrophes has rarely been reported. We present 2 such patients to remind physicians that neglected accumulation of fecal matter in the rectum may lead to ischemia and perforation of the colon and rectum.


METHODS
Report of 2 patients and a MEDLINE search of the literature.


RESULTS
In the 1st case massive fecal impaction produced an abdominal compartment syndrome and rectal necrosis. In the 2nd patient fecal impaction resulted in colonic obstruction and ischemia. In both, an operation was life-saving.


CONCLUSIONS
Neglected fecal impaction may lead to a megarectum causing an abdominal compartment syndrome and colorectal obstruction, perforation or necrosis. Measures to prevent fecal impaction are of paramount importance and prompt manual disimpaction before the above complications develop is mandatory. Appropriate operative treatment may be life-saving.
Lohlun
J
J
Department of Surgery, New York Methodist Hospital, Brooklyn, NY 11215, USA.
Margolis
M
M
Gorecki
P
P
Schein
M
M
D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003106:Colon / Q000098:blood supply; D003108:Colonic Diseases / Q000209:etiology*; D003161:Compartment Syndromes / Q000209:etiology*; D005244:Fecal Impaction / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D007511:Ischemia / Q000209:etiology; D009336:Necrosis; D012007:Rectum / Q000473:pathology / Q000601:surgery