Unusual radiographic appearance of Fecalith leading to acute abdomen in a patient consuming Iron: A Case Report

Unusual radiographic appearance of Fecalith leading to acute abdomen in a patient consuming Iron: A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Unusual radiographic appearance of Fecalith leading to acute abdomen in a patient consuming Iron: A Case Report Niharika Pathak, Megha Thapa, Sushil Sah, Prakash Pandey, Padam Raj Joshi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5211985/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Fecalith is common clinical condition, delay in diagnosis and management can lead to life threatening complications. Case Presentation : We are reporting the case of an 18 years old lady which have unusual radiographic appearance of fecalith which was diagnosed in rural emergency setting and managed with simple conservative approach. Conclusion: Fecalith can present with acute abdomen and confusing radiographic picture. It can lead to life-threatening bowel complications but can be managed conservatively with early diagnosis. Acute Abdomen Fecalith Large Radiography Figures Figure 1 Figure 2 Figure 3 Introduction And Background Fecal impaction is a frequent cause of emergency department visits.(1) Although it is an easily manageable condition, it can lead to serious complications such as bowel perforation and may become life-threatening.(2) Here, we present a case of acute abdomen caused by a fecalith which was successfully managed. Case Presentation We are reporting the case of an 18-year-old unmarried female who presented to our center with sudden onset of colicky abdominal pain. The patient described the pain similar to bearing down effort explaining like ‘something coming out of the vagina’ which progressively worsened over 24 hours and was associated with mild abdominal distension. She had not passed stool for the past 4 days and had not passed flatus for the last 24 hours. Prior to this, she gave a history of consumption of iron tablets prescribed with oral contraceptive pills. There is no history of similar episodes in the past, no history of any neurological disorder, chronic constipation, or any other medical condition. On examination, the vital signs were stable but she reported pain score of 10/10 in visual analogue scale, and the abdomen was soft with mild hypogastric tenderness. Initially, bowel or ureteric colic was suspected and we started treatment with hyoscine and intravenous ketorolac. However, the pain persisted necessitating the addition of intravenous tramadol, which also failed to provide significant relief. We ordered an abdominal radiograph which revealed a well-defined spherical radiopacity in front of the sacral bone and behind the pubic symphysis along with mild dilation of proximal bowel wall as shown in Figure 1 and 2 . This was followed by an ultrasonography which showed that the uterus and urinary bladder were normal and there was a well-defined hyperechoic lesion behind the uterus with posterior acoustic shadowing Media 1 . On per rectal examination, the perineum appeared normal with an intact anal opening, but a well-defined mass was felt, which stained the gloves with a substance resembling black mud. By making the working diagnosis of fecalith, we managed the case by digital fragmentation of the lesion followed by 200 ml of soap water enema after which she passed the stool and the pain subsided. Repeat abdominal X-Ray and ultrasonography produced normal findings Figure 3 . Later the patient was discharged with oral medication and she was doing well with no any further complain even at 1 week follow up. Discussion Fecal impaction is a common occurrence in an emergency department, typically in a patient with a history of chronic constipation. However, its presentation with severe abdominal pain along with bearing down sensation in a young female without a known co-morbidity is very unusual. ( 3 ) Previously it has been reported that high fiber diet like seeds is commonly associated with fecal impaction. Large radiopaque fecalith has been reported in some studies, the association with iron consumption, as observed in our case, is unique and warrants further investigation through well-designed study.( 4 ) ( 5 ) Our patient presented with severe abdominal pain with bearing down effort which was not controlled by first line analgesia, potentially leading us to an incorrect diagnosis. Abdominal radiography is one of the most commonly used diagnostic modality in children and adolescents and it helps in diagnosis of fecalith. We found one reported case of large fecalith which was associated with an anorectal anomaly but no any case of a large fecalith in absence of chronic anorectal condition.( 6 ) Although radiography is helpful in diagnosis of fecaliths, the radiographic findings in our case were unusual causing uncertainty in confirming diagnosis. In settings where a CT scan is unavailable, a high clinical suspicion combined with radiographic and ultrasonic studies can aid in diagnosis. ( 7 ) Digital fragmentation combined with soap water enema helps in successful management and prevention of fatal complications.( 8 ) Fecal impaction is more common in children and can potentially lead to life threating complications.( 9 ) Declarations Acknowledgement: The authors are grateful to the patient and her family members for accepting our proposal to report this case. Consent for publication: Informed written consent was taken from the patient before writing the manuscript. Competing interests: None. Funding: None. Ethical Approval: Not Applicable Authors' contribution: Dr. Padam Raj Joshi and Dr. Niharika Pathak have taken the history, performed physical examination and were involved in the management of the patient. Dr. Sushil Sah, Dr. Megha Thapa, and Dr. Prakash Pandey were involved in writing the manuscript. Dr. Padam Raj Joshi and Dr. Niharika Pathak edited and revised the manuscript. All authors read and approved the final version of the manuscript. References Hussain ZH, Whitehead DA, Lacy BE. Fecal impaction. Curr Gastroenterol Rep [Internet]. 2014 Sep 1 [cited 2024 Sep 28];16(9). https://pubmed.ncbi.nlm.nih.gov/25119877/ Mou D, Atkinson R, Valero M, Melnitchouk N. Rare but life-threatening complication of fecalith. BMJ Case Rep [Internet]. 2018 [cited 2024 Sep 8];2018. https://pubmed.ncbi.nlm.nih.gov/29991555/ Hussain ZH, Whitehead DA, Lacy BE. Fecal Impaction. Curr Gastroenterol Rep. 2014;16(9). Eitan A, Bickel A, Katz IM. Fecal impaction in adults: report of 30 cases of seed bezoars in the rectum. Dis Colon Rectum [Internet]. 2006 Nov [cited 2024 Sep 14];49(11):1768–71. https://pubmed.ncbi.nlm.nih.gov/17036204/ Muller C, Muller S, Sissoko A, Klein A, Faller B, Chantrel F. Radio-opaque fecal impaction and pseudo-occlusion in a dialyzed patient taking lanthanum carbonate. Hemodial Int [Internet]. 2012 Oct [cited 2024 Sep 28];16(4):556–8. https://pubmed.ncbi.nlm.nih.gov/22118504/ Jalil O, Jones H, Stephenson BM, Williams GL. Faecaloma in ano. Ann R Coll Surg Engl [Internet]. 2012 Mar [cited 2024 Sep 28];94(2). https://pubmed.ncbi.nlm.nih.gov/22391354/ Reuchlin-Vroklage LM, Bierma-Zeinstra S, Benninga MA, Berger MY. Diagnostic value of abdominal radiography in constipated children: a systematic review. Arch Pediatr Adolesc Med [Internet]. 2005 Jul [cited 2024 Sep 8];159(7):671–8. https://pubmed.ncbi.nlm.nih.gov/15997002/ Chakravartty S, Chang A, Nunoo-Mensah J. A systematic review of stercoral perforation. Colorectal Dis [Internet]. 2013 Aug [cited 2024 Sep 14];15(8):930–5. https://pubmed.ncbi.nlm.nih.gov/23331762/ Corban C, Sommers T, Sengupta N, Jones M, Cheng V, Friedlander E et al. Fecal Impaction in the Emergency Department: An Analysis of Frequency and Associated Charges in 2011. J Clin Gastroenterol [Internet]. 2016 Aug 1 [cited 2024 Sep 14];50(7):572–7. https://pubmed.ncbi.nlm.nih.gov/26669560/ Media Media 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files media.png Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5211985","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":364888683,"identity":"56c43abc-fe5b-4c6b-8d5b-278dfbcf67e3","order_by":0,"name":"Niharika Pathak","email":"","orcid":"","institution":"Bajhang District Hospital, Bajhang, 10500, Nepal","correspondingAuthor":false,"prefix":"","firstName":"Niharika","middleName":"","lastName":"Pathak","suffix":""},{"id":364888684,"identity":"d8af1d97-f255-405d-b56d-bf6e979ab1c4","order_by":1,"name":"Megha Thapa","email":"","orcid":"","institution":"Nepal Army Institute of Health Sciences, Syanobharyang, 44600, Kathmandu, Nepal","correspondingAuthor":false,"prefix":"","firstName":"Megha","middleName":"","lastName":"Thapa","suffix":""},{"id":364888685,"identity":"9df7c1d7-b8d6-44b9-9308-ffdb0b02a588","order_by":2,"name":"Sushil Sah","email":"","orcid":"","institution":"Rukum District Hospital, Rukum, 22000, Nepal","correspondingAuthor":false,"prefix":"","firstName":"Sushil","middleName":"","lastName":"Sah","suffix":""},{"id":364888686,"identity":"d3b42011-75d0-4ee8-888e-9fc9ad5f034c","order_by":3,"name":"Prakash Pandey","email":"","orcid":"","institution":"Sailaja Acharya Cardiac Center","correspondingAuthor":false,"prefix":"","firstName":"Prakash","middleName":"","lastName":"Pandey","suffix":""},{"id":364888687,"identity":"67ea50d5-ea2e-4c65-be6f-89ca0d78f790","order_by":4,"name":"Padam Raj Joshi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9klEQVRIiWNgGAWjYHACAwYGHiDJzNj+4QOQy8ZOvBbmNsYZIC3MRGkBk+xtzDwgFiEt5uyHN366IWNjb87O2PbY5tc2eT5mBsYPH3Nwa7HsSSuWzuFJS9zZzNhunNt327CNmYFZcuY2PK46kGMA1HI4weAwY4N0bs9tRqAWNmZefFrOvzH+DdRiD9Zi2XPbnrCWGzlmIFsYNxxmbJNm+HE7kaAWyxnPyqxBfgFqaTbsbbid3MbM2IzXL+b8yZtv5/bY2BucP/7wwY8/t23ntzcf/PARn8NABGMPlMfYBiYbcKuHaWH4AeP+wat4FIyCUTAKRigAAJ8oUDSbpXI1AAAAAElFTkSuQmCC","orcid":"","institution":"Bajhang District Hospital, Bajhang, 10500, Nepal","correspondingAuthor":true,"prefix":"","firstName":"Padam","middleName":"Raj","lastName":"Joshi","suffix":""}],"badges":[],"createdAt":"2024-10-06 08:38:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5211985/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5211985/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":67278623,"identity":"52af822a-c4d7-410e-b600-9bb70db04951","added_by":"auto","created_at":"2024-10-23 08:42:58","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":845192,"visible":true,"origin":"","legend":"\u003cp\u003eX-ray abdomen showing erect and supine views before enema. The round opacity is present in the pelvis.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5211985/v1/c5169f4f082a3126aa8f3013.png"},{"id":67279104,"identity":"d9a670d4-ef08-4b0b-b2ea-910faadfe1cd","added_by":"auto","created_at":"2024-10-23 08:50:58","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":490603,"visible":true,"origin":"","legend":"\u003cp\u003eX-ray lateral view showing the radiopacity lying in front of the sacral bone\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5211985/v1/ef44f2d0d621483fd5d4dc1f.png"},{"id":67278625,"identity":"85651f85-35ac-4222-a699-afacc8b7ec31","added_by":"auto","created_at":"2024-10-23 08:42:58","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":566093,"visible":true,"origin":"","legend":"\u003cp\u003eX-ray abdomen erect and supine views post management showing no abnormality\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5211985/v1/87cd0b56dc5ad236f4fa83ae.png"},{"id":67696235,"identity":"6cab28aa-2ddc-422e-8cd8-30c2aab17860","added_by":"auto","created_at":"2024-10-28 19:46:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2777855,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5211985/v1/5eb1f97e-890e-4df5-bb6d-f9c9cfc162dd.pdf"},{"id":67278622,"identity":"14f41ea5-c9d9-4d85-b79a-07691c7e62bc","added_by":"auto","created_at":"2024-10-23 08:42:58","extension":"png","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":12195,"visible":true,"origin":"","legend":"","description":"","filename":"media.png","url":"https://assets-eu.researchsquare.com/files/rs-5211985/v1/d9be8a547aa0cbc4b8819012.png"}],"financialInterests":"No competing interests reported.","formattedTitle":"Unusual radiographic appearance of Fecalith leading to acute abdomen in a patient consuming Iron: A Case Report","fulltext":[{"header":"Introduction And Background","content":"\u003cp\u003eFecal impaction is a frequent cause of emergency department visits.(1) Although it is an easily manageable condition, it can lead to serious complications such as bowel perforation and may become life-threatening.(2) Here, we present a case of acute abdomen caused by a fecalith which was successfully managed.\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eWe are reporting the case of an 18-year-old unmarried female who presented to our center with sudden onset of colicky abdominal pain. The patient described the pain similar to bearing down effort explaining like \u0026lsquo;something coming out of the vagina\u0026rsquo; which progressively worsened over 24 hours and was associated with mild abdominal distension. She had not passed stool for the past 4 days and had not passed flatus for the last 24 hours. Prior to this, she gave a history of consumption of iron tablets prescribed with oral contraceptive pills. There is no history of similar episodes in the past, no history of any neurological disorder, chronic constipation, or any other medical condition.\u003c/p\u003e\n\u003cp\u003eOn examination, the vital signs were stable but she reported pain score of 10/10 in visual analogue scale, and the abdomen was soft with mild hypogastric tenderness. Initially, bowel or ureteric colic was suspected and we started treatment with hyoscine and intravenous ketorolac. However, the pain persisted necessitating the addition of intravenous tramadol, which also failed to provide significant relief.\u003c/p\u003e\n\u003cp\u003eWe ordered an abdominal radiograph which revealed a well-defined spherical radiopacity in front of the sacral bone and behind the pubic symphysis along with mild dilation of proximal bowel wall as shown in \u003cstrong\u003eFigure 1 and 2\u003c/strong\u003e. This was followed by an ultrasonography which showed that the uterus and urinary bladder were normal and there was a well-defined hyperechoic lesion behind the uterus with posterior acoustic shadowing \u003cstrong\u003eMedia 1\u003c/strong\u003e. On per rectal examination, the perineum appeared normal with an intact anal opening, but a well-defined mass was felt, which stained the gloves with a substance resembling black mud. By making the working diagnosis of fecalith, we managed the case by digital fragmentation of the lesion followed by 200 ml of soap water enema after which she passed the stool and the pain subsided. Repeat abdominal X-Ray and ultrasonography produced normal findings \u003cstrong\u003eFigure 3\u003c/strong\u003e. Later the patient was discharged with oral medication and she was doing well with no any further complain even at 1 week follow up.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eFecal impaction is a common occurrence in an emergency department, typically in a patient with a history of chronic constipation. However, its presentation with severe abdominal pain along with bearing down sensation in a young female without a known co-morbidity is very unusual. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) Previously it has been reported that high fiber diet like seeds is commonly associated with fecal impaction. Large radiopaque fecalith has been reported in some studies, the association with iron consumption, as observed in our case, is unique and warrants further investigation through well-designed study.(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eOur patient presented with severe abdominal pain with bearing down effort which was not controlled by first line analgesia, potentially leading us to an incorrect diagnosis. Abdominal radiography is one of the most commonly used diagnostic modality in children and adolescents and it helps in diagnosis of fecalith. We found one reported case of large fecalith which was associated with an anorectal anomaly but no any case of a large fecalith in absence of chronic anorectal condition.(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) Although radiography is helpful in diagnosis of fecaliths, the radiographic findings in our case were unusual causing uncertainty in confirming diagnosis. In settings where a CT scan is unavailable, a high clinical suspicion combined with radiographic and ultrasonic studies can aid in diagnosis. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eDigital fragmentation combined with soap water enema helps in successful management and prevention of fatal complications.(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) Fecal impaction is more common in children and can potentially lead to life threating complications.(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAcknowledgement:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe authors are grateful to the patient and her family members for accepting our proposal to report this case.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eInformed written consent was taken from the patient before writing the manuscript.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot Applicable\u0026nbsp;\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAuthors\u0026apos; contribution:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eDr. Padam Raj Joshi and Dr. Niharika Pathak have taken the history, performed physical examination and were involved in the management of the patient. Dr. Sushil Sah, Dr. Megha Thapa, and Dr. Prakash Pandey were involved in writing the manuscript. Dr. Padam Raj Joshi and Dr. Niharika Pathak edited and revised the manuscript. All authors read and approved the final version of the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHussain ZH, Whitehead DA, Lacy BE. Fecal impaction. Curr Gastroenterol Rep [Internet]. 2014 Sep 1 [cited 2024 Sep 28];16(9). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/25119877/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/25119877/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMou D, Atkinson R, Valero M, Melnitchouk N. Rare but life-threatening complication of fecalith. BMJ Case Rep [Internet]. 2018 [cited 2024 Sep 8];2018. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/29991555/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/29991555/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHussain ZH, Whitehead DA, Lacy BE. Fecal Impaction. Curr Gastroenterol Rep. 2014;16(9).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEitan A, Bickel A, Katz IM. Fecal impaction in adults: report of 30 cases of seed bezoars in the rectum. Dis Colon Rectum [Internet]. 2006 Nov [cited 2024 Sep 14];49(11):1768\u0026ndash;71. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/17036204/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/17036204/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuller C, Muller S, Sissoko A, Klein A, Faller B, Chantrel F. Radio-opaque fecal impaction and pseudo-occlusion in a dialyzed patient taking lanthanum carbonate. Hemodial Int [Internet]. 2012 Oct [cited 2024 Sep 28];16(4):556\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/22118504/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/22118504/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJalil O, Jones H, Stephenson BM, Williams GL. Faecaloma in ano. Ann R Coll Surg Engl [Internet]. 2012 Mar [cited 2024 Sep 28];94(2). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/22391354/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/22391354/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReuchlin-Vroklage LM, Bierma-Zeinstra S, Benninga MA, Berger MY. Diagnostic value of abdominal radiography in constipated children: a systematic review. Arch Pediatr Adolesc Med [Internet]. 2005 Jul [cited 2024 Sep 8];159(7):671\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/15997002/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/15997002/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChakravartty S, Chang A, Nunoo-Mensah J. A systematic review of stercoral perforation. Colorectal Dis [Internet]. 2013 Aug [cited 2024 Sep 14];15(8):930\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/23331762/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/23331762/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCorban C, Sommers T, Sengupta N, Jones M, Cheng V, Friedlander E et al. Fecal Impaction in the Emergency Department: An Analysis of Frequency and Associated Charges in 2011. J Clin Gastroenterol [Internet]. 2016 Aug 1 [cited 2024 Sep 14];50(7):572\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/26669560/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/26669560/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Media ","content":"\u003cp\u003eMedia 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acute Abdomen, Fecalith, Large, Radiography","lastPublishedDoi":"10.21203/rs.3.rs-5211985/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5211985/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Fecalith is common clinical condition, delay in diagnosis and management can lead to life threatening complications.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Presentation\u003c/strong\u003e: We are reporting the case of an 18 years old lady which have unusual radiographic appearance of fecalith which was diagnosed in rural emergency setting and managed with simple conservative approach.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eFecalith can present with acute abdomen and confusing radiographic picture. It can lead to life-threatening bowel complications but can be managed conservatively with early diagnosis.\u003c/p\u003e","manuscriptTitle":"Unusual radiographic appearance of Fecalith leading to acute abdomen in a patient consuming Iron: A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-23 08:42:53","doi":"10.21203/rs.3.rs-5211985/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"662d5ae9-7862-494d-ae61-d54c8e09b752","owner":[],"postedDate":"October 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-10-28T19:38:20+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-23 08:42:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5211985","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5211985","identity":"rs-5211985","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}