BACKGROUND/
AIMS: Acute
intestinal obstruction is an urgent
disease to be diagnosed and treated promptly. In
elderly ,
fecal impaction may be an important and preventable cause of colonic obstruction. We investigated the clinical features of
patients presenting with denical features of
intestinal obstruction transiently due to
fecal impaction .
METHODS: From February 2001 to March 2004, nineteen
patients were diagnosed as
transient intestinal obstruction due to
fecal impaction . We evaluated clinical characteristics, radiologic findings, sigmoidoscopic or colonoscopic findings and managements.
RESULTS: Male and
female ratio was 11.1. Mean age was 79.3 years. All 19
patients had
abdominal pain and distension. On
digital rectal examination , the hard
feces was palpable in only 8
patients (42%) while others showed empty
rectum . The abnormal
laboratory findings included
leukocytosis in 5
patients (26%),
anemia in 10
patients (53%) and
electrolyte abnormalities in 7
patients (37%). Simple abdominal
X-rays showed diffuse small and/or large bowel
dilatations . In only 3
patients (16%)
air -fluid levels were definite, but most
patients showed abundant
feces in the
rectum and
colon . During
emergency sigmoidoscopy,
abdominal pain and distension were relieved and there were Bristol type 1 hard stool in the recto-
sigmoid junction in 7
patients (37%) and multiple rectal
ulcers in 1
patient . On
colonoscopy , there were no mass or pathologic obstruction in all
patients .
Patients were discharged after the adequate medication and
toilet training .
CONCLUSIONS: In
elderly patients ,
fecal impaction is odd and preventable cause of
intestinal obstruction . It is often significant to differentiate
fecal impaction from other pathologic conditions in
patients with chronic
constipation .