A Bajer, E Levine. NEJM 2025;393: e23. Stercoral Colitis

This young adult presented to the ED with left-sided abdominal pain and chronic constipation. A CT scan was consistent with a diagnosis of stercoral colitis. “In stercoral colitis, chronically impacted feces distend the colon, resulting in inflammation. In some cases, the fecaloma may lead to focal-pressure necrosis or perforation.”

My take: Most often a CT is not needed in this setting. However, it is important to recognize that a severe impaction can lead to complications.

Related blog posts:

• “Waste” of a CT Scan (The image on this post is much worse)
• Position Paper: Pediatric Refractory Constipation Management
• Long Term Use of Polyethylene Glycol (PEG 3350)
• Soap Suds Enemas & ED Management of Impactions
• Radiographs and Constipation -Bad Practice and Good Study
• ANMS Virtual Symposia on Constipation
• Pictographic Constipation Action Plan
• New Data on Bisacodyl for Pediatric Constipation
• Safety of Senna-Based Laxatives
• Constipation Action Plan: Better Instructions, Fewer Phone Calls
• Does It Make Sense to Look for Celiac Disease in Children with Functional Constipation?
• You Can Do Anorectal Manometry in Your Sleep, But Should You?
• More than Two Years of Constipation Before Specialty Help
• NASPGHAN Postgraduate Course 2017 (Part 5): Refractory constipation, Extraesophageal GERD, POTS, Recurrent Abdominal Pain
• Refractory Constipation -Terrific Update
• How Sensory Processing Contributes to Constipation in Childre