Stercoral perforation of the colon: case report and review of the literature.

Stercoral perforation of the colon is a rarely reported illness, with 67 cases reported in the literature (1). A literature review revealed no case reports in the Emergency Medicine literature. A case report of a 47-year-old female with a history of chronic constipation and sudden onset of severe abdominal pain with physical signs of peritonitis is presented. Initial hematologic and radiologic investigations were normal. After 12 h of hospitalization, a fever developed, and the signs of peritonitis continued, but her abdominal X-ray studies and white blood count remained normal. Because of her persistent abdominal findings, laparotomy was carried out, at which time a stercoral perforation of the rectum was found. A colostomy was performed. This condition is notoriously covert, but if undetected may be life-threatening. A review of the literature will highlight suspected etiologies, diagnostic tests of choice, and a preferred treatment plan.