Stercoral Colitis in Two Young Psychiatric Patients Presenting with Abdominal Pain.

BACKGROUND: Fewer than 150 cases of stercoral colitis have been reported in the literature. Stercoral colitis develops when feces impacts in the colon, resulting in increased luminal pressure, colon wall ulceration, and an inflammatory colitis. Patients are typically over the age of 60 years and have history of constipation. Mortality from colon perforation secondary to stercoral colitis is as high as 60%. CASE REPORT: We present two male patients, ages 26 and 35 years old, with history of psychiatric illness who presented with constipation and abdominal pain, who were found to have stercoral colitis on computed tomography. One patient developed stercoral perforation of the colon requiring emergent laparotomy. WHY SHOULD EMERGENCY PHYSICIANS BE AWARE OF THIS?: Stercoral colitis is a rare but potentially fatal etiology of abdominal pain that should be considered in young patients with history of constipation.