The American journal of the medical sciences · 2025
Stercoral colitis from constipation to complication: A systematic review.
СтатьяСистематический обзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stirrat Thomas, Bejugam Deeptha, Kim Stella, Dahmani Sophia, Atarere Joseph, Alukal Joseph, Kanth Priyanka
Аннотация
INTRODUCTION: Stercoral colitis is an underrecognized, life-threatening complication of refractory constipation.
METHODS: We systematically reviewed Embase, PubMed/MEDLINE, Web of Science, and CINAHL for presentation, imaging, management, and outcomes. Fifty-three studies (58 patients) met inclusion. Mean age was 55.8 years (range 9-94); 62.1% were female. Chronic constipation (75.9%) and opioid exposure (13.8%) were common. CT was used in 86.2%, showing fecaloma and wall thickening (65.5%); perforation occurred in 29.3% and ischemic colitis in 44.8%. Conservative measures, manual disimpaction, enemas, laxatives, were common; endoscopic disimpaction was rare; surgery was reserved for deterioration, peritonitis, or perforation. Overall in-hospital/30-day mortality was 22.4% (operative 26.9% vs non-operative 0.0%).
CONCLUSIONS: SC should be suspected in at-risk patients with refractory constipation; only 75.9% had abdominal pain, so its absence does not exclude disease. Early CT, especially with elevated WBC, CRP, or lactate, and severity-guided escalation to conservative therapy or timely surgery are essential; standardized criteria and prospective studies are needed.
METHODS: We systematically reviewed Embase, PubMed/MEDLINE, Web of Science, and CINAHL for presentation, imaging, management, and outcomes. Fifty-three studies (58 patients) met inclusion. Mean age was 55.8 years (range 9-94); 62.1% were female. Chronic constipation (75.9%) and opioid exposure (13.8%) were common. CT was used in 86.2%, showing fecaloma and wall thickening (65.5%); perforation occurred in 29.3% and ischemic colitis in 44.8%. Conservative measures, manual disimpaction, enemas, laxatives, were common; endoscopic disimpaction was rare; surgery was reserved for deterioration, peritonitis, or perforation. Overall in-hospital/30-day mortality was 22.4% (operative 26.9% vs non-operative 0.0%).
CONCLUSIONS: SC should be suspected in at-risk patients with refractory constipation; only 75.9% had abdominal pain, so its absence does not exclude disease. Early CT, especially with elevated WBC, CRP, or lactate, and severity-guided escalation to conservative therapy or timely surgery are essential; standardized criteria and prospective studies are needed.