Stercoral perforation of the sigmoid colon in a schizophrenic patient

Journal of Clinical and Diagnostic Research : JCDR
Shiv Kumar BunkarRohit Pratap Singh

Abstract

Stercoral perforation of the colon is a life threatening condition, due to pressure necrosis by hard fecaloma which, are commonly found in chronic constipated patients. We report the case of a 45-year-old schizophrenic woman, under psychiatric treatment for two years, presenting with a 10-day history of absolute obstipation and distension. On physical examination the patient had signs of generalized peritonitis. Preoperative diagnostic workup gave no clear-cut clues about diagnosis. Emergency laparotomy revealed a single perforation over the antimesentric border of the sigmoid colon with hard fecal matter protruding through perforation margin. A segmental resection of the sigmoid colon with colonic lavage and end to end anastomosis was performed. The patient made an uneventful recovery. We have discussed the diagnostic work-up, and the management of this rare entity. Patient was on antipsychotic, anticholenergic and NSAID'S drugs for long time with longstanding immobilisation and poor oral intake. Association of these etiological factors with chronic constipation which ultimately leads to stercoral perforation have been corroborated.

Citations

Jul 5, 2015·International Journal of Colorectal Disease·Marco SilvaGuilherme Macedo
Oct 27, 2020·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Hyung Jin LeeSanghyun Song

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