stercoral ulcer

Card Set Information

Author:
smaddineni
ID:
93777
Filename:
stercoral ulcer
Updated:
2011-07-12 15:28:20
Tags:
constipation
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Description:
constipation
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  1. def
    • constipated bedridden
    • usually isolated rectosigmoid anitmesenteric
    • ulcerating lesion less common sx hemorrhage
  2. dx of stercoral perf
    • round or ovoid
    • > 1cm diameter antimesenteric
    • fecalomas, fecalith protrudes through site of perf border necrotic
    • microscopic pressure necrosis, ulcer, or chronic inflammatory rxn
    • other path excluded
  3. Rx
    • resect
    • simple closure and diversion-high mortality, disease segmental not focal
  4. fecal impaction sequelae
    • stercolar ulcer
    • LBO
    • perf in cecum
    • gangrene and ischemia
    • autonomic dysreflexia
    • ptx from straining
    • hypoxia
    • hemorrhoids, rectal prolapse, volvulus
  5. fecal impaction-rx
    • manual disimpaction in OR, scissoring action to fragment stool, after removal high colonic irrigartion isotonic salt solutiion by large-bore catheter (standard cystoscopy irrigation), sigmoidoscopy
    • laxatives
    • large volume or retention enemas
    • PIEE device

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