case_images: PMC11271129_01
case_images: Computed tomography scan obtained at admission. Scan shows moderate stool retention and a notable thickened sigmoid. Blurred fat around the sigmoid is also visible. The hypodense structure (arrow) is noted with an appearance resembling barium.
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case_images: The patient was taken for a computed tomography (CT) scan of the abdomen/pelvis with contrast which demonstrated a moderate amount of stool in the proximal colon, leading up to a 3.2 cm hypodense structure (Figure 1).
case_images: Stool retention through gastrografin enema with no point of obstruction or foreign body.
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case_images: A gastrografin enema was obtained the next morning to evaluate for any cause of obstruction given the CT scan findings (Figure 2).
case_images: Colonoscopic image of fibrous/gallstone appearing foreign object visualized in proximal sigmoid colon.
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case_images: Colonoscopy revealed a foreign object in the proximal sigmoid colon, resembling either a gallstone or fibrous material (Figure 3).
case_images: Intraoperative findings of stercoral fecalith. In Figure (a), one can see that the epiploic fat is covering the ulceration, likely allowing the patient to remain stable and non-peritonitic. Figure (b) shows the full-thickness ulceration causing sigmoid perforation is noted. Figure (c) notes the fecalith alongside the resected bowel. This measured approximately 4 cm x 3.5 cm x 2.5 cm.
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case_images: PMC11271129_01_10.1177_2050313X241263756-fig4.jpg
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case_images: Upon separation of adjacent epiploic appendages, there was a full-thickness perforation noted with the foreign body blocking the 2 cm perforation of the sigmoid wall (Figure 4).