Pelvic Rectal Stercoral Perforation Resulting in Diffuse Pneumatosis

Anupam K Gupta; Oscar A Vazquez; Miguel Lopez-Viego

doi:10.7759/cureus.9146

Pelvic Rectal Stercoral Perforation Resulting in Diffuse Pneumatosis

Cureus. 2020 Jul 11;12(7):e9146. doi: 10.7759/cureus.9146.

Authors

Anupam K Gupta¹, Oscar A Vazquez², Miguel Lopez-Viego^{2

3}

Affiliations

¹ Minimally Invasive Surgery, University of Miami Hospital, Miami, USA.
² Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA.
³ Surgery, Bethesda Hospital, Boynton Beach, USA.

Abstract

An 83-year-old woman with oral corticosteroid use for chronic autoimmune conditions presented with abdominal pain and constipation for the previous seven days. CT of the abdomen and pelvis revealed a large fecaloma with diffuse pneumatosis involving the retroperitoneum, subcutaneous tissue, and mediastinum. An emergent exploratory laparotomy revealed perforation of the rectum below the peritoneal reflection into the retroperitoneum. An end-colostomy with Hartmann's operation was then performed intra-operatively. Despite operative treatment complicated by prolonged intubation, the patient succumbed to multiorgan failure and expired.

Keywords: fecaloma; pneumatosis; stercoral perforation; surgery.

Publication types

Case Reports