関: fecal impaction、fecaloma; 腸石

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/05/28 13:05:56」(JST)

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A fecaloma (pronounced /fiːkəˈloʊmə/, "FEE-kə-LOH-mə"), also called fecalith, fecolith and coprolith, i.e., a "stone" made of feces, is a hardening of feces into lumps of varying size inside the colon, which may appear whenever chronic obstruction of transit occurs, such as in megacolon and chronic constipation. Some diseases, such as Chagas disease, Hirschsprung's disease and others damage the autonomic nervous system in the colon's mucosa (Auerbach's plexus) and may cause extremely large or "giant" fecalomas, which must be surgically removed (disimpaction). Rarely, a fecalith will form around a hairball (Trichobezoar), or other hygroscopic or desiccant nucleus. Distal or sigmoid, fecalomas can often be disimpacted digitally or by a catheter which carries a flow of disimpaction fluid (water or other solvent or lubricant).

Fecal impaction and attempts at removal can have severe and even lethal effects, such as the rupture of the colon wall by catheter or an acute angle of the fecaloma (stercoral perforation), followed by septicemia. A small fecalith is one cause of both appendicitis and acute diverticulitis.

References

Garisto J, Campillo L, Edwards E, Harbour M, Ermocilla R (2009). "Giant fecaloma in a 12-year-old-boy: a case report" (^{[dead link]}). Cases. 2:127 (1): 127. doi:10.1186/1757-1626-2-127. PMC 2642792. PMID 19196473.

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1. 虫垂粘液嚢胞 appendiceal mucoceles
2. 成人における急性虫垂炎：臨床症状と鑑別診断 acute appendicitis in adults clinical manifestations and differential diagnosis
3. 小児における急性虫垂炎：画像診断 acute appendicitis in children diagnostic imaging
4. 消化管のシャーガス病 chagas gastrointestinal disease
5. 急性腹症を有する小児の緊急評価 emergent evaluation of the child with acute abdominal pain

English Journal

Fecalith presenting as a submucosal cecal mass.

Alhalabi SM, Alsaati G, Al-Kawas F.SourceYale School of Public Health, Yale University, New Haven, Connecticut.
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.Clin Gastroenterol Hepatol.2013 Jun;11(6):A24. doi: 10.1016/j.cgh.2012.07.010. Epub 2012 Jul 24.
PMID 22835579

Fecal impaction by rectal acerola bezoar.

Denadai R, Souza FM, Valle MR.
Indian journal of pediatrics.Indian J Pediatr.2013 May;80(5):432-3. doi: 10.1007/s12098-012-0808-7. Epub 2012 Jun 21.
PMID 22718092

Age-related changes in melatonin release in the murine distal colon.

Diss L, Robinson S, Wu Y, Fidalgo S, Yeoman MS, Patel BA.AbstractConstipation and fecal impaction are conditions of the bowel whose prevalence increases with age. Limited information is known about how these conditions manifest, however functional deficits are likely to be due to changes in signalling within the bowel. This study investigated the effects of age on colonic mucosal melatonin (MEL) release and the consequences this had on colonic motility. Electrochemical measurements of MEL overflow demonstrated that both basal and mechanically stimulated MEL release decreased with age. The MEL:serotonin also decreased with increasing age and the trend was similar to that of MEL overflow, suggestive that age-related changes were primarily due to a reduction in MEL levels. Levels of N-acetylserotonin and the N-acetylserotonin:serotonin ratio were reduced with age providing an explanation for the reduction in MEL release. Decreases in colonic motility were observed between 3 and 24 month old animals. Exogenous application of MEL could reverse this deficit in aged colon. In summary, we propose that the age-related decline in MEL release may be due to either decreases or alterations in mechanosensory channels and/or a loss in levels/activity of the N-acetyltransferase enzyme responsible for the synthesis of N-acetylserotonin. Decreases in MEL release may explain the decreases in colonic motility observed in 24 month old animals and could offer a new potential therapeutic treatment for age-related constipation.
ACS chemical neuroscience.ACS Chem Neurosci.2013 Apr 30. [Epub ahead of print]
Constipation and fecal impaction are conditions of the bowel whose prevalence increases with age. Limited information is known about how these conditions manifest, however functional deficits are likely to be due to changes in signalling within the bowel. This study investigated the effects of age o
PMID 23631514

Japanese Journal

完全内臓逆位症に合併した遊走脾茎捻転症の1例

松下航平,井上幹大,小池勇樹 [他],大竹耕平,内田恵一,三木誓雄,楠正人
日本小児外科学会雑誌 47(3), 336-340, 2011-06-20
症例は11歳の男児.完全内臓逆位症,両大血管右室起始症,単心室の診断でFontan手術施行の既往があり,抗凝固療法を継続していた.今回,右上腹部痛が出現し,CT上回盲部と思われる部位が右上腹部に存在し,糞石様の石灰化を認めたため,腸回転異常症を伴う虫垂炎を疑った.全身状態が落ち着いており,抗凝固療法を行っていたため,保存的に加療したが,翌日には痛みが腹部全体へ波及したため,緊急開腹術を施行した.開 …
NAID 110008673250

要介護高齢認知症患者に合併した糞石イレウスの1例

矢野宏行,角田美佐子,関水憲一 [他],二見章子,渡邉健太郎,猪狩吉雅,鈴木達也,中野博司,大庭建三
日本老年医学会雑誌 48(3), 289-292, 2011-05-25
NAID 10030469769

糞石腸閉塞を合併した巨大S状結腸憩室の1例

関岡敏夫,齊藤昌彦,田中俊樹,平田邦明,竹田彬一,宮阪英,野木真将,並里大,梶原正章,仲井理,山田拓司
日本大腸肛門病学会雑誌 64(3), 185-192, 2011-03-01
患者は73歳女性．2009年6月下腹部疝痛，便秘があり注腸透視を施行した．S状結腸に径3cm長さ4cmの巨大憩室を認めた．2010年1月より下腹部痛，排便困難があり大腸内視鏡検査を予定した．検査当日洗腸剤1L飲用後，腹部全体の疝痛と嘔吐を認めた．腹部は著明に膨満していた．緊急CTで大腸腸閉塞と診断した．左下腹部には7カ月前と同じ大きさの巨大S状結腸憩室を認めた．そのすぐ肛門側には4cm大の巨大糞石 …
NAID 10029095242