The following is a summary of “Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes,” published in the July 2023 issue of Emergency Medicine by Keim et al.

Stercoral colitis refers to the intestinal wall’s inflammatory condition resulting from impacted fecal matter. Despite the reported high morbidity and risk of perforation, there is a scarcity of research evaluating outcomes in this medical context. This study aims to delineate the clinical presentation, therapeutic interventions, and clinical outcomes of patients presenting to the emergency department with stercoral colitis. Researchers conducted a retrospective analysis of electronic medical records of patients who contributed to the emergency department (ED) and were diagnosed with stercoral colitis based on computed tomography (CT) imaging findings. Of 814,522 visits to multiple Emergency Departments (EDs) throughout the United States, 269 visits satisfied the inclusion criteria.

Data about patient presentation, medical intervention, and clinical outcomes were extracted from electronic health records. The findings were evaluated using percentages and 95% confidence intervals (CIs). Out of 269 patients, the age at which half were younger and half were older was determined to be 76 years. The most prevalent primary complaint reported was abdominal pain/distension, accounting for 33.8% of cases. However, the absence of abdominal pain was documented in 62.1% of cases. The most prevalent CT findings comprised fecal impaction (96.7%), inflammation of the bowel wall (72.9%), and fat stranding (48.3%). Eighty-four (31.2%) patients were discharged to their residence from the emergency department (ED), and more than half of these individuals (45/84, 53.6%) did not undergo any procedures involving enemas, laxatives, or disimpaction. Nine patients (3.3%, 95% CI 1.6% to 6.5%) necessitated surgical intervention for a complication associated with the condition within three months.

Additionally, 27 individuals (10.0%, 95% CI 6.8% to 14.4%) sought medical attention at the emergency department within 72 hours. Furthermore, nine patients (3.3%, 95% CI 1.6% to 6.5%) succumbed to a cause directly linked to stercoral colitis within three months. Individuals diagnosed with stercoral colitis frequently exhibit non-specific clinical manifestations, and the occurrence of short-term mortality is significant. Most discharged patients did not receive the recommended treatment in this medical study. This study represents the most extensive emergency department (ED) investigation of stercoral colitis, a medical condition characterized by colon inflammation due to fecal impaction. The findings of this study offer additional evidence that supports the association between stercoral colitis and unfavorable health outcomes.

Source: sciencedirect.com/science/article/abs/pii/S0196064423000987