Successful Resolution of Fecal Impaction During Endoscopy Using a Looped Guidewire

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  • Okada Tomoyuki
    Tottori Prefectural Central Hospital, Tottori 680-0901, Japan and
  • Yanagitani Atsushi
    Tottori Prefectural Central Hospital, Tottori 680-0901, Japan and
  • Hashimoto Takeshi
    Tottori Prefectural Central Hospital, Tottori 680-0901, Japan and
  • Isomoto Hajime
    Division of Medicine and Clinical Science, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan

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<p>Fecal impaction is the impaired excretion of a large fecal mass, and mild cases are treated by enema and osmotic laxatives. However, treatment-resistant cases need more invasive alternatives. A woman in her 60s presented with abdominal discomfort. Her abdomen was soft and without tenderness. Computed tomography revealed a large mass of feces in her sigmoid colon and no intestinal dilatation proximal to the mass. Endoscopy confirmed a fecal mass occupying the lumen. A glycerin enema, oral administration of polyethylene glycol, and enteral administration of amidotrizoic acid during colonoscopy were ineffective. We maneuvered a guidewire to form a loop at the tip of an endoscope, with which we subdivided the mass for successful removal. The patient’s abdominal discomfort disappeared immediately. Endoscopic disimpaction is far less invasive than surgery and should be considered when treating fecal impaction cases, without severe obstructive colitis, which are nonresponsive to conservative treatment.</p>

収録刊行物

  • Yonago Acta Medica

    Yonago Acta Medica 64 (1), 129-132, 2021

    ヨナゴ・アクタ・メディカ刊行会

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