[Transient intestinal obstruction due to stool impaction in the elderly].
OBJECTIVE
Acute intestinal obstruction is an urgent disease to be diagnosed and treated promptly. In elderly, fecal impaction may be an important and preventable cause of colonic obstruction. We investigated the clinical features of patients presenting with identical features of intestinal obstruction transiently due to fecal impaction.


METHODS
From February 2001 to March 2004, nineteen patients were diagnosed as transient intestinal obstruction due to fecal impaction. We evaluated clinical characteristics, radiologic findings, sigmoidoscopic or colonoscopic findings and managements.


RESULTS
Male and female ratio was 1:1.1. Mean age was 79.3 years. All 19 patients had abdominal pain and distension. On digital rectal examination, the hard feces was palpable in only 8 patients (42%) while others showed empty rectum. The abnormal laboratory findings included leukocytosis in 5 patients (26%), anemia in 10 patients (53%) and electrolyte abnormalities in 7 patients (37%). Simple abdominal X-rays showed diffuse small and/or large bowel dilatations. In only 3 patients (16%) air-fluid levels were definite, but most patients showed abundant feces in the rectum and colon. During emergency sigmoidoscopy, abdominal pain and distension were relieved and there were Bristol type 1 hard stool in the recto-sigmoid junction in 7 patients (37%) and multiple rectal ulcers in 1 patient. On colonoscopy, there were no mass or pathologic obstruction in all patients. Patients were discharged after the adequate medication and toilet training.


CONCLUSIONS
In elderly patients, fecal impaction is odd and preventable cause of intestinal obstruction. It is often significant to differentiate fecal impaction from other pathologic conditions in patients with chronic constipation.
Byun
Young Hye
YH
Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
Park
Young Sook
YS
Myung
Seok Jin
SJ
Eom
Woo Youn
WY
Choi
Won Wook
WW
Kim
Tae Hun
TH
Jo
Yun Ju
YJ
Kim
Seong Hwan
SH
Song
Moon Hee
MH
D000368:Aged; D000369:Aged, 80 and over; D005244:Fecal Impaction / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male