Case report on small bowel obstruction secondary to ileal fecaloma

Introduction: Fecaloma is a rare medical condition in which a laminated mass of accumulated feces is much harder in consistency than a fecal impaction. Risk factors for fecaloma include disorders that cause constipation. Despite this, fecaloma may occur in the absence of risk factors. Case presentation: We report a 48-year-old woman who presented with small bowel obstruction due to an ileal fecaloma with no identifiable risk factors or history of surgery. The patient was managed initially conservatively for 12 hours. After 12 hours, the fecaloma was removed via enterotomy, and the patient was discharged with a good outcome. Discussion: Even though fecal impaction is common, especially in the elderly, fecaloma is an extremely rare form of impaction. Fecaloma can present as an abdominal mass, stercoral colitis, urinary retention, or intestinal obstruction. Fecaloma is diagnosed radiologically when the characteristic intraluminal mass is visualized on plain X-rays, barium enema, or abdominal computed tomography (CT). Treatment options include conservative management with bowel rest, laxatives, endoscopic removal, laparotomy, and removal via enterotomy. Conclusion: Fecaloma should be considered in patients with small bowel obstruction without any risk factors, especially when the patient has a history of chronic constipation before the onset of bowel obstruction. Abdominal CT scan with contrast is helpful when available; however, clinical judgment and timely surgical intervention remain vital in resource-limited settings where gold -standard imaging is unavailable.