Stercoral Colitis

Stercoral colitis is a rare inflammatory colitis caused by increased intraluminal and colonic wall pressure from a fecaloma (large mass of dry, hard stool), which leads to decreased blood supply. If left untreated, it can cause ulceration and perforation. In about 75% of cases, the ulcers are found in the sigmoid colon or rectum, with the most common locations being the anterior rectum just proximal to the peritoneal reflection; the antimesenteric border of the rectosigmoid junction; and the apex of the sigmoid colon.

On CT, in a region of fecal impaction, there is thickening of the colonic wall and stranding of the pericolonic fat. Extraluminal bubbles of gas and an abscess suggest perforation.

References

Heffernan C, Pachter HL, Megibow AJ, Macari M. Stercoral colitis leading to fatal peritonitis: CT findings. AJR Am J Roentgenol. 2005 Apr;184(4):1189-93.