Unusual etiology of lower digestive bleeding in a patient with constipation

• Autores: Flores-Egocheaga, Luis Enrique, Puente De La Vega-Cáceres, Eloy, Bellido-Caparó, Álvaro
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Sociedad de Gastroenterología del Perú
• Repositorio: Revista de Gastroenterología del Perú
• Lenguaje: español
• OAI Identifier: oai:ojs.revistagastroperu.com:article/1793
• Enlace del recurso: https://revistagastroperu.com/index.php/rgp/article/view/1793
• Nivel de acceso: acceso abierto
• Materia: Colitis; Impactación Fecal; Dolor Abdominal; Fecal Impaction; Abdominal Pain

The stercoral colitis is an inflammatory caused by fecal impactation. The etiology is poorlymanaged chronic constipation in specific risk groups. Patients usually present with abdominalpain, abdominal distension, and fever; in severe cases, peritoneal signs, shock or multiorganfailure may occur. It is important to have a high index of suspicion and request an abdominalCT scan with contrast. Treatment is conservative in the absence of peritoneal signs orhemodynamic instability; otherwise, management is surgical. We present the case of an86-year-old male with a history of ischemic stroke, dysmobility and chronic constipation thatpresented with hematochezia. The imaging study showed thickening of the wall of the distalsigmoid colon and rectum, as well as feces inside. The endoscopic study revealed ulcers in therectum and the recto-sigmoid junction. Conservative treatment with enemas and laxativeswas indicated, with favorable clinical evolution.