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Stercoral Ulcers

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1. Stercoral Ulcer Not Always Indolent: A Rare Complication of Fecal Impaction (PubMed)

Stercoral Ulcer Not Always Indolent: A Rare Complication of Fecal Impaction Stercoral sigmoid perforation is a dangerous surgical emergency. It is also a life-threatening situation because the spillage of fecal contents into the abdominal cavity leads to sepsis with many postoperative complications. Chronic, intermittent constipation can lead to fecal impaction, especially in older patients. An 80-year-old male patient presented with intestinal abdominal pain and distention for three days. His (...) chest X-ray showed air under the diaphragm. On laparotomy, a small rent was discovered in the rectosigmoid junction with fecal contamination. The presence of a fecaloma is the speculated reason for the perforation. Primary closure of the defect with a diverting transverse colostomy was performed, and subsequently, the patient recovered well. A colostomy closure was performed six weeks after the primary surgery. It is imperative to understand the incidence of stercoral perforation in a normal bowel

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2018 Cureus

2. Hemospray as the Initial Treatment of a Lower Gastrointestinal Bleed Resulting from Stercoral Ulceration (PubMed)

Hemospray as the Initial Treatment of a Lower Gastrointestinal Bleed Resulting from Stercoral Ulceration Stercoral ulceration, an uncommon complication of constipation and fecal impaction, can present as a significant lower gastrointestinal bleed. Endoscopic management of this complication is rarely described in the literature. We describe the first documented case of an individual with massive hematochezia in the setting of stercoral ulceration being managed with Hemospray (Cook Medical

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2018 ACG case reports journal

3. Stercoral Ulcer-Associated Perforation and Chemotherapy (PubMed)

Stercoral Ulcer-Associated Perforation and Chemotherapy Stercoral ulcer perforation is a life-threatening surgical condition which is thought to result from necrosis of the bowel wall due to an ischemic pressure by stool. This condition usually afflicts patients with chronic constipation. CT scan can identify most of the cases and emergent surgery is usually indicated.

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2017 Case reports in oncology

4. Stercoral Ulcers

Stercoral Ulcers Stercoral Ulcers Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stercoral Ulcers Stercoral Ulcers Aka: Stercoral (...) Ulcers From Related Chapters II. Risk Factors Chronic debility or immobility III. Pathophysiology Pressure necrosis from firm, immobile stool mass Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Stercoral Ulcers." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Inflammatory Bowel Disease About FPnotebook.com is a rapid access, point

2018 FP Notebook

5. Stercoral colitis complicated with ischemic colitis: a double-edge sword. (PubMed)

Stercoral colitis complicated with ischemic colitis: a double-edge sword. Stercoral colitis is a rare inflammatory process involving the colonic wall secondary to fecal impaction with high morbidity and mortality; especially if complicated with ischemic colitis, stercoral ulcer formation and subsequent perforation. There are several case reports published on abdominal perforation resulting from stercoral colitis. However, stercoral colitis complicated by ischemic colitis is rare. The purpose (...) of this case report is to describe the potential challenges in the diagnosis and management of stercoral colitis with ischemic colitis.An 87 years old male with history of chronic constipation presents with severe abdominal pain to the emergency department. The patient was hemodynamically stable. On physical examination, the abdomen was mildly distended with moderate tenderness. Lab work was significant for leukocytosis and lactic acidosis. Abdominal CT scan revealed large amount of retained stool

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2017 BMC Gastroenterology

6. Stercoral Ulcers

Stercoral Ulcers Stercoral Ulcers Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stercoral Ulcers Stercoral Ulcers Aka: Stercoral (...) Ulcers From Related Chapters II. Risk Factors Chronic debility or immobility III. Pathophysiology Pressure necrosis from firm, immobile stool mass Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Stercoral Ulcers." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Inflammatory Bowel Disease About FPnotebook.com is a rapid access, point

2015 FP Notebook

7. Stercoral Colitis in Two Young Psychiatric Patients Presenting with Abdominal Pain. (PubMed)

Stercoral Colitis in Two Young Psychiatric Patients Presenting with Abdominal Pain. Fewer than 150 cases of stercoral colitis have been reported in the literature. Stercoral colitis develops when feces impacts in the colon, resulting in increased luminal pressure, colon wall ulceration, and an inflammatory colitis. Patients are typically over the age of 60 years and have history of constipation. Mortality from colon perforation secondary to stercoral colitis is as high as 60%.We present two (...) male patients, ages 26 and 35 years old, with history of psychiatric illness who presented with constipation and abdominal pain, who were found to have stercoral colitis on computed tomography. One patient developed stercoral perforation of the colon requiring emergent laparotomy. WHY SHOULD EMERGENCY PHYSICIANS BE AWARE OF THIS?: Stercoral colitis is a rare but potentially fatal etiology of abdominal pain that should be considered in young patients with history of constipation.Copyright © 2015

2015 Journal of Emergency Medicine

8. Lower gastrointestinal bleeding caused by stercoral ulcer (PubMed)

Lower gastrointestinal bleeding caused by stercoral ulcer 21173065 2011 04 05 2018 11 13 1488-2329 183 2 2011 Feb 08 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Lower gastrointestinal bleeding caused by stercoral ulcer. E134 10.1503/cmaj.100621 Huang Cheng-Chiang CC Departments of Radiology, Kuo General Hospital, Tainan, Taiwan. Wang I-Fu IF Chiu Hsin-Hui HH eng Case Reports Journal Article 2010 12 20 Canada CMAJ 9711805 0820-3946 AIM IM Aged (...) , 80 and over Colonic Diseases complications diagnosis Colonoscopy Constipation complications Fecal Impaction complications diagnosis Gastrointestinal Hemorrhage etiology Humans Male Tomography, X-Ray Computed Ulcer complications diagnosis 2010 12 22 6 0 2010 12 22 6 0 2011 4 6 6 0 ppublish 21173065 cmaj.100621 10.1503/cmaj.100621 PMC3033957 Gastrointest Endosc. 1997 Oct;46(4):369-70 9351047 World J Gastroenterol. 2008 Apr 28;14(16):2615-6 18442219 Gastrointest Endosc. 1998 Nov;48(5):559 9831859

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2011 CMAJ : Canadian Medical Association Journal

9. Production and prevention of stercoral ulcers in the rat. (PubMed)

Production and prevention of stercoral ulcers in the rat. 5904502 1966 05 19 2018 11 13 0002-9440 48 2 1966 Feb The American journal of pathology Am. J. Pathol. Production and prevention of stercoral ulcers in the rat. 299-303 Selye H H Winandy G G Gabbiani G G eng Journal Article United States Am J Pathol 0370502 0002-9440 2YHB6175DO Cyproheptadine 333DO1RDJY Serotonin AIM IM Animals Aorta Colon, Sigmoid Cyproheptadine pharmacology Feces Rats Rectal Diseases Serotonin toxicity Ulcer 1966 2 1

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1966 The American journal of pathology

10. Diagnosis, Assessment and Management of Constipation in Advanced Cancer: ESMO Clinical Practice Guidelines

, stercoral ulcers and rectal bleeding [76, 77]. Recommendation: • In the absence of suspected perforation or bleed, the manage- ment of faecal impaction involves disimpaction (usually through digital fragmentation and extraction of the stool), followed by the implementation of a maintenance bowel regi- men to prevent recurrence [V, B] [75–78]. Management ofconstipation in theelderly cancer patient Aetiology. Ageing causes a degenerative process in the enteric ner- vous system. The effect of cancer (...) Perineal inspection Digitalrectal examination Distension Abdominal masses Liver enlargement Tenderness Increased/decreased bowel sounds Skin tags Fissures Prolapse Anal warts Perianal ulceration Inner haemorrhoids Sphincter tone Tenderness Obstruction/stenosis Impacted faeces Complete absence of stool Tumour masses Blood Clinical Practice Guidelines Annals of Oncology iv116 | Larkin et al. Volume 29 | Supplement 4 | October 2018 Downloaded from https://academic.oup.com/annonc/article-abstract/29

2018 European Society for Medical Oncology

11. NASPGHAN Clinical Report: Surveillance, Diagnosis, and Prevention of Infectious Diseases in Pediatric Patients with Inflammatory Bowel Disease Receiving Tumor Necrosis Factor - alpha Inhibitors

(IBD) has evolved considerably and increasingly includes the use of biologic therapies such as tumor necrosis factora inhibitors (anti- TNFa). In patients with IBD, anti-TNFa therapies such as inflix- imab and adalimumab are effective in inducing and maintaining remission in patients with moderate to severe Crohn disease (CD) including fistulizing, perianal, and steroid-unresponsive disease and in patients with steroid-dependent, severe, or refractory ulcerative colitis (UC). The goals of therapy (...) disease; RESEAT¼ retrospective evaluation of the safety and effect of adalimumab therapy; UC¼ ulcerative colitis. JPGN Volume 63, Number 1, July 2016 NASPGHAN Clinical Report www.jpgn.org 131 Copyright © ESPGHAL and NASPGHAN. All rights reserved. professionals with information regarding the risk of serious infec- tions and guidance for prevention, surveillance, and diagnosis of infections in pediatric patients with IBD who are or will be receiving anti-TNFa therapies. In general, any pediatric

2016 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

12. The Value of Post-operative Antibiotic Therapy After Laparoscopic Appendectomy for Complicated Acute Appendicitis (Other Than for Generalized Peritonitis)

Immunodepressed patients Diabetic patients Patients who have received an antibiotic treatment within 3 months before the surgery (and having a potential impact on the intestinal flora) Related to the diagnosis: other diseases (Crohn's disease, ulcerative colitis, treatment with an immunosuppressive therapy). Related to the severity of the appendicitis: A Saint-Antoine score of 4 or 5 (non-complicated acute appendicitis) Severe sepsis, septic shock, generalized peritonitis Related to the treatment: A decision (...) person who could be present at home and provide assistance in case of any problem for the discharged patient Per-operative exclusion criteria (related to the severity of appendicitis): Non-complicated forms (catarrhal appendicitis or the absence of extraluminal fecaliths, abscess or peritonitis). Generalized purulent or stercoral peritonitis (the presence of pus or faeces in more than two quadrants of the abdomen). In order to assess the reproducibility of the inclusion criteria in the various

2018 Clinical Trials

13. Should Colon or Non-colon Originated Lesions be Distinguished?

for eligibility information Ages Eligible for Study: 18 Years to 75 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Patients in our ICU aged 18-75 years. Patients with a confirmed diagnosis of ALGID. Exclusion Criteria: mechanical intestinal obstruction (including tumor, stercoral obstruction etc.) gastrointestinal hemorrhage within 72 hours. history of inflammatory bowel disease (ulcerative colitis or Crohn's disease) or radiation enteritis

2016 Clinical Trials

14. Wild Banana Seed Phytobezoar Rectal Impaction Causing Intestinal Obstruction (PubMed)

Wild Banana Seed Phytobezoar Rectal Impaction Causing Intestinal Obstruction Wild banana (Musa acuminata subsp. microcarpa) seed phytobezoar rectal impaction in adult is a rare entity. Here, we report a 75-year-old male with dementia who presented with lower abdominal pain, per-rectal bleeding and overflow faecal incontinence. Our investigation discovered a large wild banana seed phytobezoar impacted in the rectum causing intestinal obstruction, stercoral ulcer and faecal overflow incontinence

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2015 The Indian journal of surgery

15. Lower Gastrointestinal Bleeding: Surgical Perspective (Diagnosis)

, but up to 10% may cause small intestinal bleeding. Small intestinal adenomatous polyps, leiomyomas, Peutz-Jeghers syndrome, and hemangiomas may cause occult or frank LGIB. Other uncommon causes of LGIB include stercoral ulcers. Previous Next: Epidemiology Lower gastrointestinal bleeding (LGIB) that requires hospitalization represents less than 1% of all hospital admissions in the United States. [ ] In one study, the estimated annual incidence rate was 20.5 patients per 100,000 (24.2 in males vs 17.2 (...) that affect elderly persons older than 60 years. Most colonic angiodysplasias are degenerative lesions that arise from chronic, intermittent, low-grade colonic contraction that obstructs the mucosal venous drainage. Over time, mucosal capillaries dilate, become incompetent, and form an AVM. Colitis Massive hemorrhage due to inflammatory bowel disease (IBD) is rare. Ulcerative colitis causes bloody diarrhea in most cases. In up to 50% of patients with ulcerative colitis, mild to moderate LGIB occurs

2014 eMedicine Surgery

16. Megacolon, Chronic (Diagnosis)

of the bowel or to stercoral ulcer. If the etiology is overdistention, perforation typically occurs in the cecum. Stercoral ulcers typically occur in the sigmoid/rectosigmoid region. Previous Next: Patient Education Education of the patient with regard to the strict bowel program is essential to management. Maintaining effective management requires extensive effort and discipline from both the health care provider and the patient. To this end, educating the patient about the entire process is crucial (...) of intrinsic nervous control of colonic motility is via postganglionic nerves: stimulatory cholinergic nerves and inhibitory nitric oxide-releasing nerves. Evidence suggests that excessive production of nitric oxide may be the mechanism for toxic megacolon in ulcerative colitis; as yet, there is no evidence for a possible role of nitric oxide in chronic megacolon unrelated to inflammatory bowel disease. Studies in mouse models and in children with chronic colonic pseudo-obstruction show abnormalities

2014 eMedicine.com

17. Lower Gastrointestinal Bleeding (Diagnosis)

, but up to 10% may cause small intestinal bleeding. Small intestinal adenomatous polyps, leiomyomas, Peutz-Jeghers syndrome, and hemangiomas may cause occult or frank LGIB. Other uncommon causes of LGIB include stercoral ulcers. Previous Next: Epidemiology Lower gastrointestinal bleeding (LGIB) that requires hospitalization represents less than 1% of all hospital admissions in the United States. [ ] In one study, the estimated annual incidence rate was 20.5 patients per 100,000 (24.2 in males vs 17.2 (...) than 60 years. Most colonic angiodysplasias are degenerative lesions that arise from chronic, intermittent, low-grade colonic contraction that obstructs the mucosal venous drainage. Over time, mucosal capillaries dilate, become incompetent, and form an AVM. Colitis Massive hemorrhage due to inflammatory bowel disease (IBD) is rare. Ulcerative colitis causes bloody diarrhea in most cases. In up to 50% of patients with ulcerative colitis, mild to moderate LGIB occurs, and approximately 4% of patients

2014 eMedicine.com

18. Constipation (Diagnosis)

and responds to treatment of constipation. In adults, surgical or gastroenterologic consultation may be required to differentiate benign solitary rectal ulcers from rectal malignancy. Other complications of constipation may include the following: Fecal impaction Bowel obstruction Stercoral ulceration/perforation Megacolon Volvulus Rectal prolapse Urinary retention Fistula in ano Previous Next: Patient Education Patient education typically involves instructions for improving dietary management. Dietary (...) . [ ] Employing univariate analysis, they reported odds ratios of 2.36 for constipation and 2.46 for obstetric trauma associated with pelvic floor damage. On the basis of their data, the authors suggested that constipation and obstetric trauma are equally important in the development of pelvic floor damage. The chronic pressure effect of hard stools against the anterior rectal wall when the patient strains during defecation is believed to cause solitary rectal ulcers. This is usually a self-limiting process

2014 eMedicine.com

19. Constipation (Overview)

and responds to treatment of constipation. In adults, surgical or gastroenterologic consultation may be required to differentiate benign solitary rectal ulcers from rectal malignancy. Other complications of constipation may include the following: Fecal impaction Bowel obstruction Stercoral ulceration/perforation Megacolon Volvulus Rectal prolapse Urinary retention Fistula in ano Previous Next: Patient Education Patient education typically involves instructions for improving dietary management. Dietary (...) . [ ] Employing univariate analysis, they reported odds ratios of 2.36 for constipation and 2.46 for obstetric trauma associated with pelvic floor damage. On the basis of their data, the authors suggested that constipation and obstetric trauma are equally important in the development of pelvic floor damage. The chronic pressure effect of hard stools against the anterior rectal wall when the patient strains during defecation is believed to cause solitary rectal ulcers. This is usually a self-limiting process

2014 eMedicine.com

20. Megacolon, Chronic (Overview)

of the bowel or to stercoral ulcer. If the etiology is overdistention, perforation typically occurs in the cecum. Stercoral ulcers typically occur in the sigmoid/rectosigmoid region. Previous Next: Patient Education Education of the patient with regard to the strict bowel program is essential to management. Maintaining effective management requires extensive effort and discipline from both the health care provider and the patient. To this end, educating the patient about the entire process is crucial (...) of intrinsic nervous control of colonic motility is via postganglionic nerves: stimulatory cholinergic nerves and inhibitory nitric oxide-releasing nerves. Evidence suggests that excessive production of nitric oxide may be the mechanism for toxic megacolon in ulcerative colitis; as yet, there is no evidence for a possible role of nitric oxide in chronic megacolon unrelated to inflammatory bowel disease. Studies in mouse models and in children with chronic colonic pseudo-obstruction show abnormalities

2014 eMedicine.com

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