Advanced Practice: Stercoral Colitis with Obstructive Acute Kidney Injury
Fecal impaction is most often observed in elderly with chronic constipation. It may also be observed in those with neurologic disorders or those on chronic opiates.
Massive fecal impaction can lead to increased pressure on distended bowel wall leading to ischemia, ulceration and eventual perforation. Perforation is associated with a mortality as high as 35%.
Management of stercoral colitis includes manual disimpaction, aggressive bowel regimen, consultation with surgery for potential bowel resection and prophylactic antibiotics.
1. Heffernan, C et al. (2005). Stercoral colitis leading to fatal peritonitis: CT findings. American Journal Roentgenology 184:1189-1193.