Fecal impaction with stercoral perforation of the cecum in pregnancy - ( case report of a rare entity)

Abstract

Abstract : Stercoral perforation of colon is a rare entity occurring mainly in the left colon in elderly population with underlying chronic constipation. About 100 cases of stercoral perforation are reported and most of them are in the sigmoid and recto sigmoid. Mortality is more than 30 and most patients are managed by resection with diversion of colon. Stercoral perforation of colon in pregnancy is very rare and there are only 4 cases reported in English literature. Fetal loss is common. We report a case of contained cecal perforation in second trimester of pregnancy in a woman with fecal impaction and over distended cecum. She presented with constipation and was found to develop peritonism during treatment of fecal impaction. She was managed with resection and primary anastomosis with favorable outcome of pregnancy without fetal loss. Stercoral perforation of cecum is not conservative reported in pregnancy and this is possibly the first report of favorable obstetric outcome managed by primary resection anastomosis as the perforation was contained and detected early.