Gastroenterology Book

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Fecal Impaction

Aka: Fecal Impaction
  1. See Also
    1. Constipation
  2. Definition
    1. Firm, hard, dry immovable stool in Rectum or distal colon creating a partial or complete blockage
  3. Risk factors
    1. Elderly
    2. Immobile patients
      1. Incidence 1% in hospitalized patients
    3. Spinal cord injury patients
      1. Incidence: 13%
    4. Chronic Opioid use
    5. Hypothyroidism
    6. Low fiber diet
  4. Symptoms
    1. Constipation
    2. Diarrhea
      1. Frequent passage of small loose or liquid stools
      2. Results from leakage of stool around the impaction
      3. May result in overflow Fecal Incontinence
  5. Signs
    1. Firm, immovable mass of stool on rectal exam
  6. Imaging: Abdominal XRay
    1. Large stool collection in Rectum and sigmoid colon
  7. Differential Diagnosis
    1. See Constipation Causes
    2. Diverticulitis
  8. Precautions: Red Flags suggesting other diagnosis
    1. Fever
    2. Bloody Diarrhea
    3. Leukocytosis
  9. Management
    1. Disimpaction with rectal exam
    2. Warm water or saline lavage
      1. Instill by rectal tube or Flexible Sigmoidoscopy
    3. Mineral Oil enema (or oral if no risk of aspiration)
    4. Dilatation of anus under general anesthesia
    5. Oral Polyethylene glycol (Miralax)
      1. Effective in 89% of cases
      2. Chen (2005) 21(10): 1595-602 [PubMed]
  10. References
    1. Creason (2000) Nurs Diagn 11(1): 15-23 [PubMed]
    2. Fargo (2012) Am Fam Physician 85(6): 624-30 [PubMed]

Fecal Impaction (C0015734)

Definition (CCC) Feces wedged in intestine
Definition (MSH) Formation of a firm impassable mass of stool in the RECTUM or distal COLON.
Concepts Finding (T033)
MSH D005244
ICD9 560.32
ICD10 K56.41
SnomedCT 44635007, 27666002, 263880007, 266524003, 155782005, 67409000, 62851005
LNC MTHU013359
English FECAL IMPACTION, FAECAL IMPACTION, Fecalith, Faecalith, Stool impaction, Coprostasis, fecal impaction (diagnosis), fecal impaction, impacted with stool, impacted with feces, fecal impaction (physical finding), Coprolith, Stercolith, fecal impaction was discovered, Impaction, Fecal impaction NOS, Impaction fecal, Fecal Impaction [Disease/Finding], rndx fecal impaction, rndx fecal impaction (diagnosis), impacted stools, fecal impactions, feces impacted, impacted faeces, impacted feces, impacted stool, Fecal impaction in rectum, Scybala, Fecal impaction (excl obstruction), Impaction faecal, Scybalum (morphologic abnormality), Scybalum, Faecalith (morphologic abnormality), Faecal impaction (excl obstruction), Impaction, Fecal, Fecal Impaction, Fecal impaction of rectum, Faecal impaction, Fecal impaction, Impacted faeces, Impacted feces, Impacted stool in rectum, Faecal impaction of rectum, Faeces - impacted, Fecal impaction (disorder), Fecal impaction (morphologic abnormality), Feces - impacted, coprolith, coprostasis, fecal; impaction, fecalith, impaction; fecal, stercolith, Faecal impaction (excluding obstruction), Fecal impaction (excluding obstruction), faecal impaction
Italian Coprolito, Impatto fecale (ostruzione esclusa), Impatto fecale NAS, Impatto fecale, Coprostasi, Stercolito, Fecaloma
Dutch fecale impactie NAO, impactie fecaal, fecale impactie (excl. obstructie), fecale impactie, coprostase, stercoliet, coproliet, faecaal; impactie, impactie; faecaal, fecoliet, Faecoliet, Feces, geïmpacteerde, Geïmpacteerde feces
French Fécalome (excl obstruction), Fécalithe, Matières fécales impactées, Impaction fécale (excl occlusion), Impaction fécale SAI, Coprostase, RETENTION DE MATIERES FECALES, Stercolithe, Coprolithe, Fécalome, Impaction fécale
German gestauter Kot, Kotstau ( ausschl Obstruktion), Kotstau NNB, Kotstau, Koprostase, Stauung, Kot, Kotstau (ausschl Obstruktion), Koprolith, Sterkolith, KOPROSTASE, Kotstein, Stuhlimpaktion
Portuguese Impactação fecal, Impactação fecal NE, Impactação fecal (excl. obstrução), Coprólito, Retenção de fezes, Coprostase, RETENCAO DE MATERIAS FECAIS, Estercólito, Impactação Fecal, Fecalito, Impacção Fecal
Spanish Impactación fecal, Heces impactadas, Impactación fecal (excl obstrucción), Impactación fecal NEOM, Coprostasis, Coprolito, Estercolito, IMPACTACION FECAL, impactación fecal, impactación fecal (trastorno), impactación fecal del recto (trastorno), heces impactadas en el recto, impactación fecal del recto, escíbalo, escíbalo (anomalía morfológica), retención fecal (anomalía morfológica), retención fecal, Fecalito, Impactación Fecal
Japanese 宿便NOS, 宿便(閉塞を除く), シュクベン, シュクベンヘイソクヲノゾク, フンセキ, シュクベンNOS, 腸石(糞石), 糞石, 腸結石(糞石), 宿便, 結石-糞便
Swedish Fekal klumpbildning
Finnish Ulostekovettuma
Russian KALOVYE KAMNI, KALOVYE MASSY UPLOTNENNYE, FEKAL'NYE ZAKUPORKI, KALOVYE ZAKUPORKI, КАЛОВЫЕ ЗАКУПОРКИ, КАЛОВЫЕ КАМНИ, КАЛОВЫЕ МАССЫ УПЛОТНЕННЫЕ, ФЕКАЛЬНЫЕ ЗАКУПОРКИ
Czech Zaklíněná stolice NOS, Skybala, Zaklíněná stolice, Koprostáze, Sterkolit, Zaklíněná stolice (kromě obstrukce), Koprolit, hromadění stolice, feces - nahromadění, nahromadění stolice
Polish Zaleganie stolca, Wklinowanie kałowe, Kamień kałowy
Hungarian Faecolith, Faeces impactio, Coprostasis, Coprolith, Széklet beékelődés, Faeces impactio k.m.n., Széklet impactio (kivéve obstructio), Faeces impactio (kivéve obstructio), Impactált faeces, Faecalis impactio, Fecalith, Faeces beékelődés, Stercolith
Norwegian Fekal impaksjon
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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