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A systematic review of stercoral perforation
Author(s) -
Chakravartty S.,
Chang A.,
NunooMensah J.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12123
Subject(s) - medicine , perforation , constipation , surgery , abdominal pain , medline , general surgery , punching , materials science , political science , law , metallurgy
Aim Stercoral perforation is a rarely suspected life‐threatening condition. Early diagnosis is difficult but essential. A comprehensive systematic review was performed to evaluate its presentation, diagnosis and treatment. Method A systematic review was carried out of Embase, MEDLINE , PubMed and Cochrane databases for all articles published between 1998 and 2011. Only studies describing stercoral perforation were included. Results Twenty‐four relevant articles were found including 137 patients (median age = 62 years) with stercoral perforation, of whom 81% had chronic constipation. Stercoral perforation was diagnosed by CT scan in 90% of 31 patients, with the commonest findings being a combination of faecal impaction (84%) and subphrenic (90%) or extraluminal air (61%). The commonest site of perforation was the sigmoid colon (50%) followed by the rectosigmoid junction (24%). The overall mortality was 34%. Conclusion Stercoral perforation should be suspected in elderly and chronically constipated patients with unexplained abdominal pain and investigated appropriately with a CT scan to allow timely and optimal treatment.