Coprostasis
| Classification according to ICD-10 | |
|---|---|
| K56.4 | Other obturation of the intestine |
| K38.1 | Appendix concrements |
| ICD-10 online (WHO version 2019) | |
A coprostasis ( compound from ancient Greek κόπρος , kópros , "feces" and στάσις , stásis , "behavior"; English: coprostasis or fecal impaction ) is the stasis of feces in the large intestine (stool impaction), especially the rectal ampulla with difficult defecation . This can lead to the formation of fecal balls ( skybala ) or fecal stones , which can completely prevent emptying from the rectum. These balls of feces can optionally also be felt through the abdominal wall and are then referred to as coprom (also: sterkorom or feculom ). Released colon secretions can bypass the standing column of feces and simulate diarrhea , but more often lead to fecal incontinence . The filling of the rectum can trigger the defecation reflex (especially when sitting) , which can lead to considerable pain.
Patients can complain of flatulence and pain (often in the right lower abdomen as well), so that a suspected diagnosis of appendicitis can also be made.
Chronic coprostasis can u. a. in the case of an unsuitable diet , chronic laxative intake in the event of constipation , lack of physical activity (bed rest / immobilization), insufficient fluid intake over a long period of time or other disorders of the intestinal peristalsis .
Complications: Peritonitis through migration , possibly also intestinal infections, occurring states of intoxication ( autointoxication ) as copraemia .
therapy
For children, “chair training” or “chair training ” is recommended in milder cases. There are evidence-based recommendations for laxatives such as macrogol . Enemas (including high enemas ) are mainly given in nursing homes, less often in children. If they are ineffective, a digital evacuation of the rectum is carried out. If necessary, the administration of painkillers is indicated. As a last resort, in particular in closure in the proximal colon and a surgical intervention may be necessary.
Individual evidence
- ^ Pschyrembel clinical dictionary . 261st edition. Walter de Gruyter, 2007
- ^ FW Leung, pp. Rao: Fecal incontinence in the elderly . In: Gastroenterol Clin North Am. , 2009 Sep, 38 (3), pp. 503-511, PMID 19699410 .
- ↑ G Sgourakis et al .: Are acute exacerbations of chronic inflammatory appendicitis triggered by coprostasis and / or coproliths? In: World J Gastroenterol. , 2008 May 28, 14 (20), pp. 3179-3182, PMID 18506922 .
- ^ D Candy, J. Belsey: Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review . In: Arch Dis Child . 2009 Feb, 94 (2), pp. 156-160, PMID 19019885 . Epub 2008 Nov 19.
- ↑ E Bárcena Fernández et al .: Saline enemas as treatment of faecal impaction in pediatric emergencies . In: To Pediatr (Barc). , 2009 Sep, 71 (3), pp. 215-220, PMID 19646939 (Spanish). Epub 2009 Jul 30.
- ↑ D Raahave et al .: colectomy for refractory constipation . In: Scand J Gastroenterol. , 2010 May, 45 (5), pp. 592-602, PMID 20408774 .
