title: Colonic obstruction secondary to sigmoid fecaloma endoscopically resolved with Coca-Cola®.
abstract: BACKGROUND
  Colonic obstruction is a relatively common condition in emergency care, with a mortality rate of up to 20%. In 90% of cases it results from colonic or rectal adenocarcinoma, volvulus, or stenosis secondary to diverticular disease. When fecal impaction is the underlying cause, the condition is usually managed conservatively, but may on occasion become complicated and even require surgical intervention. Based on the proven efficacy of Coca-Cola® to dissolve gastric phytobezoars, we report a case of colonic obstruction secondary to sigmoid fecaloma.
  
  
  METHODS
  A 58 years old woman arrived at the Emergency Room (ER) with persistent constipation for the last six days. An abdominal CT scan showed a large fecal mass at the sigmoid colon with retrograde dilated colonic loops. Cleansing enemas and oral lactulose were administered, which failed to resolve the clinical presentation, so we then proceeded to inject Coca-Cola® within the fecaloma using a sclerosing needle, and then washed the fecaloma surface also with Coca-Cola®. After a few minutes we started to fragment the fecalith, the consistency of which had been notably decreased.
  
  
  CONCLUSIONS
  The use of Coca-Cola® for gastric washes in the management of phytobezoars is well established. Since fecaliths are partly composed of these same substances than phytobezoars, the use of Coca-Cola® might well be warranted against them as in our patient, without surgery. Our case report is the second one published in the literature, in which Coca-Cola® helped solve colonic obstruction secondary to fecaloma.
authors.affiliation: UGC Aparato Digestivo, Hospital Universitario Virgen del Rocío, España.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ontanilla Clavijo
authors.affiliation: UGC Aparato Digestivo, Hospital Universitario Virgen del Rocío.
authors.forename: Rafael
authors.initials: R
authors.lastname: León Montañés
authors.affiliation: UGC Aparato Digestivo, Hospital Universitario Virgen del Rocío.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Sánchez Torrijos
authors.affiliation: UGC Aparato Digestivo, Hospital Universitario Virgen del Rocío.
authors.forename: Teófilo
authors.initials: T
authors.lastname: López Ruiz
authors.affiliation: UGC Aparato Digestivo, Hospital Universitario Virgen del Rocío.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Bozada García
mesh_terms: D002253:Carbonated Beverages; D016099:Endoscopy, Gastrointestinal; D004733:Enema; D005244:Fecal Impaction / Q000000981:diagnostic imaging / Q000628:therapy*; D005243:Feces; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed