Successful Removal of Hard Sigmoid Fecaloma Using Endoscopic Cola Injection

Jong Jin Lee; Jeong Wook Kim

doi:10.4166/kjg.2015.66.1.46

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Lee and Kim: Successful Removal of Hard Sigmoid Fecaloma Using Endoscopic Cola Injection

Case Report

Korean J Gastroenterol 2015;66(1):46-49.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.66.1.46

Successful Removal of Hard Sigmoid Fecaloma Using Endoscopic Cola Injection

Jong Jin Lee, Jeong Wook Kim

Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea

Correspondence to: Jeong Wook Kim, Center of Digestive Disease, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Korea. Tel: +82-2-6299-1355, Fax: +82-2-6918-6824, E-mail: ekg001@cau.ac.kr

Received 29 December 2014 Revised 20 January 2015 Accepted 11 February 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Colorectal fecaloma is hardening of feces into lumps of varying size that is much harder in consistency than a fecal impaction. Complications of colorectal fecaloma include ulceration, bleeding, perforation and obstruction of the colon. Most fecalomas are successfully removed by conservative treatment with laxatives, enemas and rectal evacuation to relieve fecal impaction. When conservative treatments have failed, a surgical intervention may be needed. Herein, we report a case of 4.7 cm sized sigmoid fecaloma showing no response to conservative treatments that was successfully removed by endoscopic fragmentation with Coca-Cola injection instead of surgery.

Keywords: Fecal impaction, Sigmoid colon, Cola, Endoscopy

References

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Fig. 1.

Erect simple abdomen (A) and supine simple abdomen (B) demonstrate accumulation of bowel gas in the sigmoid colon (arrows).

Fig. 2.

Colonoscopy shows a huge hard round-shaped fecaloma in the sigmoid colon.

Fig. 3.

Abdominopelvic CT reveals a 4.7 cm sized fecaloma in the distal sigmoid colon (arrows).

Fig. 4.

Endoscopic findings. (A) Coca-Cola is injected to the fecaloma using injector. (B) Fecaloma is broken into smaller pieces using a snare.(C) The fecaloma is finally fragmented.

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