Portal de Periódicos da CAPES

Stercoral Perforation of the Colon

1998; Elsevier BV; Volume: 15; Issue: 5 Linguagem: Inglês

10.1016/s0740-5472(98)00025-7

1873-6483

Timothy D Haley, Charles D. Long, Barry D. Mann,

Health Services Management and Policy

Stercoral ulceration, a defect in the colonic wall caused by an inflammatory response to impacted feces, is a very rare cause of spontaneous perforation of the colon. A recent review of the literature by Serpell and Nicholls 1990 Serpell J.W. Nicholls R.J. Stercoral perforation of the colon. British Journal of Surgery. 1990; 77: 1325-1329 Crossref PubMed Scopus (126) Google Scholar revealed only 64 reported cases since the original description of stercoral ulceration by Berry 1894 Berry J. Dilatation and rupture of sigmoid flexture. British Medical Journal. 1894; i: 301 Google Scholar . In the majority of these cases, there is an antecedent history of severe constipation. Many constipating medications have been associated with this disease, including antidepressants, nonsteroidal anti-inflammatory medications, aluminum-based antacids, and narcotics, in both the abusive and analgesic setting ( Aguillo, Zincke, & Woods 1976 Aguillo J.J. Zincke H. Woods J.E. Intestinal perforation due to faecal impaction after renal transplantation. Journal of Urology. 1976; 116: 153-155 PubMed Google Scholar , Cass 1978 Cass A.J. Stercoral perforation Case of drug-induced impaction. British Medical Journal. 1978; 2: 932-933 Crossref PubMed Scopus (11) Google Scholar , Hollingworth & Alexander-Williams 1991 Hollingworth J. Alexander-Williams J. Non-steroidal anti-inflamotory drugs and stercoral perforation of the colon. Annals of the Royal College of Surgeons of England. 1991; 73: 337-340 PubMed Google Scholar , Stringer, Greenfield, & McIrvine 1987 Stringer M.D. Greenfield S. McIrvine A.J. Stercoral perforation of the colon following postoperative analgesia. Journal of the Royal Society of Medicine. 1987; 80: 115-116 PubMed Google Scholar ). Though methadone is known to have the same constipating properties as other narcotics ( Goodman & Gilman 1990 Goodman L.S. Gilman A. The pharmacological basis of therapeutics. 8. Pergamon Press, New York1990 Google Scholar ), to our knowledge methadone has not specifically been reported as an etiologic agent. Herein, we report on a patient who developed a stercoral perforation of the colon while on methadone maintenance therapy.