The patient is a 90-year-old woman with a history of chronic constipation. She described abdominal pain that had been progressing for one week with associated overflow diarrhea, nausea and vomiting. Lab work showed deterioration of renal function with a creatinine level of 3.23mg/dL. CT scan revealed a large fecaloma that occupied the rectal ampulla, sigmoid and descending colon, which extended to the epigastrium and had a maximum craniocaudal length of 35cm, lateral diameter of 12.7cm and anteroposterior of 14.8cm. The fecaloma was compressing the right pelvic ureter, causing uretero-pyelocaliceal dilation and changes associated with obstructive uropathy and hydronephrosis (Fig. 1).
We extracted the fecaloma manually under sedation, after which creatinine levels and intestinal transit normalized progressively.
Please cite this article as: Perfecto Valero A, Serrano Hermosilla C, Aranda Escaño E, Tellaeche de la Iglesia M. Hidronefrosis derecha por fecaloma. Cir Esp. 2019;97:407.
