S Chakravartty1, A Chang, J Nunoo-Mensah. 1. Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK. saurav_tty@yahoo.com
Abstract
AIM: Stercoral perforation is a rarely suspected life-threatening condition. Early diagnosis is difficult but essential. A comprehensive systematic review was performed to evaluate its presentation, diagnosis and treatment. METHOD: A systematic review was carried out of Embase, MEDLINE, PubMed and Cochrane databases for all articles published between 1998 and 2011. Only studies describing stercoral perforation were included. RESULTS: Twenty-four relevant articles were found including 137 patients (median age = 62 years) with stercoral perforation, of whom 81% had chronic constipation. Stercoral perforation was diagnosed by CT scan in 90% of 31 patients, with the commonest findings being a combination of faecal impaction (84%) and subphrenic (90%) or extraluminal air (61%). The commonest site of perforation was the sigmoid colon (50%) followed by the rectosigmoid junction (24%). The overall mortality was 34%. CONCLUSION: Stercoral perforation should be suspected in elderly and chronically constipated patients with unexplained abdominal pain and investigated appropriately with a CT scan to allow timely and optimal treatment. Colorectal Disease
AIM: Stercoral perforation is a rarely suspected life-threatening condition. Early diagnosis is difficult but essential. A comprehensive systematic review was performed to evaluate its presentation, diagnosis and treatment. METHOD: A systematic review was carried out of Embase, MEDLINE, PubMed and Cochrane databases for all articles published between 1998 and 2011. Only studies describing stercoral perforation were included. RESULTS: Twenty-four relevant articles were found including 137 patients (median age = 62 years) with stercoral perforation, of whom 81% had chronic constipation. Stercoral perforation was diagnosed by CT scan in 90% of 31 patients, with the commonest findings being a combination of faecal impaction (84%) and subphrenic (90%) or extraluminal air (61%). The commonest site of perforation was the sigmoid colon (50%) followed by the rectosigmoid junction (24%). The overall mortality was 34%. CONCLUSION: Stercoral perforation should be suspected in elderly and chronically constipatedpatients with unexplained abdominal pain and investigated appropriately with a CT scan to allow timely and optimal treatment. Colorectal Disease
Authors: Kristin Schwab; Sepehr Hamidi; Augustine Chung; Raymond J Lim; Negar Khanlou; Daniel Hoesterey; Camelia Dumitras; Oladunni B Adeyiga; Michelle Phan-Tang; Tisha S Wang; Rajan Saggar; Jeffrey Goldstein; John A Belperio; Steven M Dubinett; Jocelyn T Kim; Ramin Salehi-Rad Journal: Open Forum Infect Dis Date: 2020-09-12 Impact factor: 3.835