title: Successful endoscopic fragmentation of large hardened fecaloma using jumbo forceps.
abstract: We present a rare case of fecaloma, 7 cm in size, in the setting of systemic scleroderma. A colonoscopy revealed a giant brown fecaloma occupying the lumen of the colon and a colonic ulcer that was caused by the fecaloma. The surface of the fecaloma was hard, large and slippery, and fragmentation was not possible despite the use of various devices, including standard biopsy forceps, an injection needle, and a snare. However, jumbo forceps were able to shave the surface of the fecaloma and break it successfully by repeated biting for 6 h over 2 d. The ability of the jumbo forceps to collect large mucosal samples was also appropriate for achieving fragmentation of the giant fecaloma.
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasuda
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Nakano
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Hattori
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Ozawa
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Shun-Ichiro
authors.initials: SI
authors.lastname: Ozawa
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamashita
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Itoh
keywords: Fecaloma; Jumbo biopsy forceps; Mixed connective tissue disease; Systemic scleroderma