Perforated Stercoral Ulceration of Transverse Colon in the Setting of Multiple Comorbidities: A Case Report

Stercoral colitis is an inflammatory condition resulting from the long-term collection of fecal matter that may lead to colonic ulceration and perforation, consequently representing a surgical emergency. Herein, we present the case of a 65-year-old female who developed stercoral ulceration of the transverse colon, an uncommon location of occurrence. The patient had multiple comorbid conditions and risk factors for stercoral colitis that included a history of constipation, major depressive disorder, hypothyroidism, and a partial colonic resection due to an upper rectal perforation secondary to diverticulitis. With features of peritonitis on physical examination, historical, and computed tomography findings, the patient underwent urgent open abdominal exploration with colonic resection of the impacted bowel and end transverse colostomy. The patient had a complicated postoperative course owing to a respiratory infection and intraabdominal abscess formation but adequately recovered to be discharged home. Thus, urgent surgical intervention is necessary for survival in patients with stercoral ulceration, but modification of risk factors may be crucial in preventing stercoral colitis and its potentially fatal complications.