II. Pathophysiology

  1. Fecal Impaction may cause bowel wall inflammation
  2. Stercoral Ulcers may result in pressure necrosis from firm, immobile stool mass

III. Risk Factors

  1. Chronic debility or immobility resulting in severe Constipation and impaction

IV. Imaging

  1. Stercoral Colitis
    1. CT Abdomen diagnosis demonstrates significant Fecal Impaction with secondary bowel wall inflammation
    2. Wide spectrum of severity (with risk of bowel perforation in severe cases)

V. Management: Stercoral Colitis

  1. Start with manual disimpaction followed by enemas
  2. Older or debilitated patients may require hospitalization for aggressive bowel management
  3. Surgery Consultation Indications
    1. Bowel Perforation
    2. Bowel dilation >6 cm
    3. Bowel wall thickness >3 cm

VI. References

  1. Swaminathan and Shoenberger (2026) EM:Rap, 4/27/2026

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