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Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy
Fecalomas most commonly occur in constipated patients and are rarely reported after colectomy. A 55-year-old Japanese female presented with a fecaloma after colectomy, which was impacted at a functional end-to-end anastomosis (FEEA) site. Four and a half years ago, she underwent sigmoidectomy for co...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8787506/ https://www.ncbi.nlm.nih.gov/pubmed/35110987 http://dx.doi.org/10.1159/000521127 |
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author | Homma, Yuko Mimura, Toshiki Sadatomo, Ai Koinuma, Koji Horie, Hisanaga Lefor, Alan Kawarai Sata, Naohiro |
author_facet | Homma, Yuko Mimura, Toshiki Sadatomo, Ai Koinuma, Koji Horie, Hisanaga Lefor, Alan Kawarai Sata, Naohiro |
author_sort | Homma, Yuko |
collection | PubMed |
description | Fecalomas most commonly occur in constipated patients and are rarely reported after colectomy. A 55-year-old Japanese female presented with a fecaloma after colectomy, which was impacted at a functional end-to-end anastomosis (FEEA) site. Four and a half years ago, she underwent sigmoidectomy for colon cancer. A follow-up computed tomography (CT) scan revealed an 11 cm incidental fecaloma. The patient was advised to undergo surgery, but she desired nonoperative management because of minimal symptoms, and was referred to our institution. On the day of admission (day 1), mechanical fragmentation of the fecaloma was attempted during the first colonoscopy. Although a large block of stool was evacuated after a second colonoscopic fragmentation on day 8, the third colonoscopy on day 21 and CT scan on day 22 showed no significant change in the fecaloma. Frequent colonoscopic fragmentation was performed, with a fourth, fifth, and sixth colonoscopy on days 24, 29, and 31, respectively. After the size reduction was confirmed at the sixth colonoscopy, the patient was discharged home on day 34. The fecaloma completely resolved after the seventh colonoscopic fragmentation on day 44. Sixteen months after treatment, there is no evidence of recurrent fecaloma. According to the literature, risk factors for fecaloma after colectomy include female gender, left-side colonic anastomosis, and FEEA. FEEA might not be recommended for anastomoses in the left colon, particularly in female patients, to avoid this complication. Colonoscopic fragmentation is recommended for fecalomas at an anastomotic site after colectomy in patients without an absolute indication for surgery. |
format | Online Article Text |
id | pubmed-8787506 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-87875062022-02-01 Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy Homma, Yuko Mimura, Toshiki Sadatomo, Ai Koinuma, Koji Horie, Hisanaga Lefor, Alan Kawarai Sata, Naohiro Case Rep Gastroenterol Single Case Fecalomas most commonly occur in constipated patients and are rarely reported after colectomy. A 55-year-old Japanese female presented with a fecaloma after colectomy, which was impacted at a functional end-to-end anastomosis (FEEA) site. Four and a half years ago, she underwent sigmoidectomy for colon cancer. A follow-up computed tomography (CT) scan revealed an 11 cm incidental fecaloma. The patient was advised to undergo surgery, but she desired nonoperative management because of minimal symptoms, and was referred to our institution. On the day of admission (day 1), mechanical fragmentation of the fecaloma was attempted during the first colonoscopy. Although a large block of stool was evacuated after a second colonoscopic fragmentation on day 8, the third colonoscopy on day 21 and CT scan on day 22 showed no significant change in the fecaloma. Frequent colonoscopic fragmentation was performed, with a fourth, fifth, and sixth colonoscopy on days 24, 29, and 31, respectively. After the size reduction was confirmed at the sixth colonoscopy, the patient was discharged home on day 34. The fecaloma completely resolved after the seventh colonoscopic fragmentation on day 44. Sixteen months after treatment, there is no evidence of recurrent fecaloma. According to the literature, risk factors for fecaloma after colectomy include female gender, left-side colonic anastomosis, and FEEA. FEEA might not be recommended for anastomoses in the left colon, particularly in female patients, to avoid this complication. Colonoscopic fragmentation is recommended for fecalomas at an anastomotic site after colectomy in patients without an absolute indication for surgery. S. Karger AG 2021-12-27 /pmc/articles/PMC8787506/ /pubmed/35110987 http://dx.doi.org/10.1159/000521127 Text en Copyright © 2021 by The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Single Case Homma, Yuko Mimura, Toshiki Sadatomo, Ai Koinuma, Koji Horie, Hisanaga Lefor, Alan Kawarai Sata, Naohiro Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy |
title | Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy |
title_full | Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy |
title_fullStr | Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy |
title_full_unstemmed | Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy |
title_short | Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy |
title_sort | colonoscopic treatment of a fecaloma at the anastomotic site after colectomy |
topic | Single Case |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8787506/ https://www.ncbi.nlm.nih.gov/pubmed/35110987 http://dx.doi.org/10.1159/000521127 |
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