title: [Stercoral perforation of the colon: case report and literature review].
abstract: BACKGROUND
  Colon perforation has several causes, including stercoral perforation of the colon, which was first described in 1894. Currently, reported cases are fewer than 100.
  
  
  METHODS
  Male patient of 67 years old, treated at Huichapan General Hospital, Hidalgo, Mexico, with abdominal pain, bloating and no bowel movements. He referred being constipated for the last ten years. Imaging revealed an extremely dilated sigmoid colon with fecal matter as well as free gas in the peritoneal cavity. The suspicion of stercoral colonic perforation is established. Exploratory laparotomy was performed immediately, finding a perforation and a hard scybalum protruding in the ascending colon. Colectomy, ileostomy and Hartmann's pouch are performed. After surgery, the condition of the patient worsened and progressed to septic shock and respiratory failure. The patient died four hours after surgery, with the diagnosis of organ failure due to sepsis.
  
  
  METHODS
  Stercoral perforation accounts for 3.2% of all colon perforations and is caused by a rupture of the intestinal wall through direct pressure of a fecaloma on the colon. It occurs especially in patients older than 70 years with severe chronic constipation, weakened and/or are hospitalized with multiple medications and immobilized.
  
  
  CONCLUSIONS
  Stercoral perforation of the colon is a rare cause of bowel perforation, which should be suspected in patients with a history of chronic constipation, acute abdominal pain, bloating and sepsis, in order to intervene in a timely fashion.
authors.forename: José Francisco Camacho
authors.initials: JF
authors.lastname: Aguilera
authors.forename: Rosa Edith Arenas
authors.initials: RE
authors.lastname: Lugo
authors.forename: Ariadne Waldo
authors.initials: AW
authors.lastname: Luna
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000368:Aged; D012809:Colon, Sigmoid / Q000473:pathology; D003108:Colonic Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003248:Constipation / Q000209:etiology*; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007813:Laparotomy / Q000379:methods; D008297:Male