Mechanical Obstruction of Bowel and Megacolon Caused by Fecal Impaction

Fecal impaction is a common condition, which may lead to dilatation of bowel loop and perforation of colon in rare cases. Surgical intervention may be needed while the obstruction can not be resolved by medical method. This 67 y/o man is a case with previous history of diabetes mellitus and ischemic cerebral infarction one year before his admission. He had been bed-ridden for half a year. He was admitted to this hospital due to respiratory failure Investigation revealed marked dilated colonic bowel loop. Under the impression of mechanical bowel obstruction, the patient received exploratory laparotomy. Fecal impaction as well as megacolon were the operative findings. The fecalith was squeezed downward gradually and then removed by digital evacuation through the anus. In a case of mechanical ileus, the possibility of fecal impaction should be kept in mind and evaluated by detailed examination.