title: A systematic review of stercoral perforation.
abstract: OBJECTIVE
  Stercoral perforation is a rarely suspected life-threatening condition. Early diagnosis is difficult but essential. A comprehensive systematic review was performed to evaluate its presentation, diagnosis and treatment.
  
  
  METHODS
  A systematic review was carried out of Embase, MEDLINE, PubMed and Cochrane databases for all articles published between 1998 and 2011. Only studies describing stercoral perforation were included.
  
  
  RESULTS
  Twenty-four relevant articles were found including 137 patients (median age = 62 years) with stercoral perforation, of whom 81% had chronic constipation. Stercoral perforation was diagnosed by CT scan in 90% of 31 patients, with the commonest findings being a combination of faecal impaction (84%) and subphrenic (90%) or extraluminal air (61%). The commonest site of perforation was the sigmoid colon (50%) followed by the rectosigmoid junction (24%). The overall mortality was 34%.
  
  
  CONCLUSIONS
  Stercoral perforation should be suspected in elderly and chronically constipated patients with unexplained abdominal pain and investigated appropriately with a CT scan to allow timely and optimal treatment.
authors: Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK. saurav_tty@yahoo.com
authors: S
authors: S
authors: Chakravartty
authors: A
authors: A
authors: Chang
authors: J
authors: J
authors: Nunoo-Mensah
mesh_terms: D003248:Constipation / Q000150:complications*; D005244:Fecal Impaction / Q000150:complications*; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011859:Radiography
keywords: Stercoral; constipation; rectal perforation; stercoral perforation