This is a 58-year-old woman with a history of hypertension and dyslipidemia who, due to episodes of meteorism, took punctually clebopride/symeticone prescribed by her primary care physician.
She came to the emergency room with constipation for a period of six days, which was added the day before going to the emergency room nausea and vomiting.
Also, since the third day the patient had diffuse abdominal colic pain.
Upon arrival at the Emergency Room, urgent laboratory tests were extracted and an abdominal X-ray was requested in a standing position.
The laboratory tests showed a predominance of neutrophils (74.6%), with no alterations in the rest of the leukocyte series, kidney function and neutrophils 19.110.
Abdominal X-ray showed colonic air-fluid levels. An abdominal CAT scan revealed the presence of a large mass of fecal material impacted on the sigmoid colon.
Then, the patient went to the observation area, where the administration of cleaning enemas and oral lactulose was performed, without resolution of the condition.
Subsequently, an attempt was made to facilitate fecal transit with glycerin enemas without success.
At this time, after a joint evaluation with surgery, it was decided, given the possibility of having to surgically intervene the patient, to attempt to endoscopically disimpact the fecaloma.
Located in our experience in the use of Coca-Cola® for the treatment of gastric phytobezoar and the experience in its use in other centers in this type of pathology, we personally acquire this product
After a detailed explanation of the risks to the patient, we proceeded to perform fecaloma in which, with low insensitivity to avoid complications.
We then proceeded with placement of a Coca-Cola® needle inside the fecaloma and then irrigate its surface with it, using a total volume of 500 ml.
After several minutes of action of the product we began to fragment the fecal bolus, whose consistency had decreased markedly after the action of Coca-Cola®, using a polypectomy loop.
After cleaning and disimpaction of the fecal bolus a loop with hyperemic mucosa and a large fibrinous ulceration was observed as data of ischemic suffering of the colon wall.
After fecal disimpaction, the patient restored normal intestinal transit and was discharged 24 hours after the endoscopic procedure without complications.
