Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction

A fecaloma is a mass of accumulated feces with a consistency much harder than that of a fecal impaction. It is most frequently observed in the rectum and sigmoid area, and associated complications include colonic obstruction, ulceration, bleeding, and perforation. A one-year-old, previously healthy...

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Main Authors: Risa Kanai, Kengo Nakaya, Koji Fukumoto, Masaya Yamoto, Hiromu Miyake, Akiyoshi Nomura, Susumu Yamada, Akihiro Makino, Hideto Iwafuchi, Naoto Urushihara
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2021/8815907
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author Risa Kanai
Kengo Nakaya
Koji Fukumoto
Masaya Yamoto
Hiromu Miyake
Akiyoshi Nomura
Susumu Yamada
Akihiro Makino
Hideto Iwafuchi
Naoto Urushihara
author_facet Risa Kanai
Kengo Nakaya
Koji Fukumoto
Masaya Yamoto
Hiromu Miyake
Akiyoshi Nomura
Susumu Yamada
Akihiro Makino
Hideto Iwafuchi
Naoto Urushihara
author_sort Risa Kanai
collection DOAJ
description A fecaloma is a mass of accumulated feces with a consistency much harder than that of a fecal impaction. It is most frequently observed in the rectum and sigmoid area, and associated complications include colonic obstruction, ulceration, bleeding, and perforation. A one-year-old, previously healthy boy with no history of chronic constipation was admitted because of vomiting and abdominal distension. An abdominal computed tomography scan showed small and large bowel distension due to multiple obstructive fecalomas in the transverse colon. As the fecalomas could not be resolved by laxatives, enemas, or colonic lavage, endoscopic disimpaction under general anesthesia was attempted. Repeatedly shaving the fecalomas with biopsy forceps finally resulted in gradual fragmentation with subsequent passage. Gastrointestinal food allergy was later suggested as the cause because eosinophilic infiltration was found in a biopsy specimen of the colon wall. Endoscopic disimpaction is an effective treatment approach for addressing fecalomas to avoid more invasive surgical intervention.
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language English
publishDate 2021-01-01
publisher Wiley
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series Case Reports in Pediatrics
spelling doaj-art-4b9b7a905c1242daa55445a2aa9597732025-08-20T02:38:41ZengWileyCase Reports in Pediatrics2090-68032090-68112021-01-01202110.1155/2021/88159078815907Obstructive Fecalomas in an Infant Treated with Successful Endoscopic DisimpactionRisa Kanai0Kengo Nakaya1Koji Fukumoto2Masaya Yamoto3Hiromu Miyake4Akiyoshi Nomura5Susumu Yamada6Akihiro Makino7Hideto Iwafuchi8Naoto Urushihara9Department of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pathology, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanDepartment of Pediatric Surgery, Shizuoka Children’s Hospital, Address: 860, Urushiyama Aoi-ku Shizuoka-shi, Shizuoka 420-8660, JapanA fecaloma is a mass of accumulated feces with a consistency much harder than that of a fecal impaction. It is most frequently observed in the rectum and sigmoid area, and associated complications include colonic obstruction, ulceration, bleeding, and perforation. A one-year-old, previously healthy boy with no history of chronic constipation was admitted because of vomiting and abdominal distension. An abdominal computed tomography scan showed small and large bowel distension due to multiple obstructive fecalomas in the transverse colon. As the fecalomas could not be resolved by laxatives, enemas, or colonic lavage, endoscopic disimpaction under general anesthesia was attempted. Repeatedly shaving the fecalomas with biopsy forceps finally resulted in gradual fragmentation with subsequent passage. Gastrointestinal food allergy was later suggested as the cause because eosinophilic infiltration was found in a biopsy specimen of the colon wall. Endoscopic disimpaction is an effective treatment approach for addressing fecalomas to avoid more invasive surgical intervention.http://dx.doi.org/10.1155/2021/8815907
spellingShingle Risa Kanai
Kengo Nakaya
Koji Fukumoto
Masaya Yamoto
Hiromu Miyake
Akiyoshi Nomura
Susumu Yamada
Akihiro Makino
Hideto Iwafuchi
Naoto Urushihara
Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction
Case Reports in Pediatrics
title Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction
title_full Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction
title_fullStr Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction
title_full_unstemmed Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction
title_short Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction
title_sort obstructive fecalomas in an infant treated with successful endoscopic disimpaction
url http://dx.doi.org/10.1155/2021/8815907
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