Fecal impaction causing megarectum-producing colorectal catastrophes - A report of two cases

Purpose: Massive fecal impaction leading to surgical catastrophes has rarel y been reported. We present 2 such patients to remind physicians that negle cted accumulation of fecal matter in the rectum may lead to ischemia and pe rforation of the colon and rectum. Methods: Report of 2 patients and a MEDL INE search of the literature. Results: In the ist case massive fecal impact ion produced an abdominal compartment syndrome and rectal necrosis. In the 2nd patient fecal impaction resulted in colonic obstruction and ischemia. I n both, an operation was life-saving. Conclusion: Neglected fecal impaction may lead to a megarectum causing an abdominal compartment syndrome and col orectal obstruction, perforation or necrosis. Measures to prevent fecal imp action are of paramount importance and prompt manual disimpaction before th e above complications develop is mandatory. Appropriate operative treatment may be life-saving. Copyright (C) 2000 S, Karger AG. Basel.