Presentation
Chronic constipation, presented with lower abdominal pain and fever. History of left femoral neck fracture a few months ago treated with medication and rehabilitation.
Patient Data
Age: 80 years
Gender: Female
From the case:
Stercoral perforation - sigmoid colon
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/99725/annotated_viewer_json?lang=us"}
The CT scan shows:
- distended colon filled with feces
- large rectal fecaloma with mural thickening
- focal perforation of the right lateral wall of the sigmoid colon (15 mm) with adjacent extraluminal collection (gas/feces) as well as perisigmoid free air and fat stranding.
- other findings:
- left femoral neck fracture
- thrombosis of the common femoral veins (certainly due to the prolonged immobilization)
- partially thrombosed aneurysm of the splenic artery
From the case:
Stercoral perforation - sigmoid colon
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/99727/annotated_viewer_json?lang=us"}
Red arrows: site of sigmoid perforation
Case Discussion
CT features of a stercoral perforation of the sigmoid colon with parasigmoid collection (air/feces) secondary to a rectal fecaloma, which was confirmed at surgery.
In this case, the fracture of the femoral neck with immobilization is considered as a risk factor for the development of fecaloma and deep vein thrombosis.
Additional contributor; A. Ramdani, MD
Unable to process the form. Check for errors and try again.