Matsuo Y, Yasuda H, Nakano H, Hattori M, Ozawa M, Sato Y, Ikeda Y, Ozawa SI, Yamashita M, Yamamoto H, Itoh F. Successful endoscopic fragmentation of large hardened fecaloma using jumbo forceps. World J Gastrointest Endosc 2017; 9(2): 91-94 [PMID: 28250902 DOI: 10.4253/wjge.v9.i2.91]
Corresponding Author of This Article
Yasumasa Matsuo, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, Kanagawa 216-8511, Japan. yasumasa_matsuo@marianna-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yasumasa Matsuo, Hiroshi Yasuda, Hiroyasu Nakano, Miki Hattori, Midori Ozawa, Yoshinori Sato, Yoshiko Ikeda, Shun-Ichiro Ozawa, Masaki Yamashita, Hiroyuki Yamamoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan
Author contributions: Matsuo Y and Yasuda H designed the report; Matsuo Y, Nakano H, Hattori M, Ozawa M, Sato Y, Ozawa SI, Yamashita M and Yamamoto H were attending doctors for the patient; Itoh F organized the report; Matsuo Y wrote the paper.
Institutional review board statement: Because present report is not a clinical study, this report was not reviewed by the institutional review board.
Informed consent statement: Written informed consent for endoscopic intervention was obtained from the patient and patient’s families.
Conflict-of-interest statement: Authors have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yasumasa Matsuo, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, Kanagawa 216-8511, Japan. yasumasa_matsuo@marianna-u.ac.jp
Telephone: +81-44-9778111 Fax: +81-44-9750608
Received: July 2, 2016 Peer-review started: July 4, 2016 First decision: August 22, 2016 Revised: September 27, 2016 Accepted: October 22, 2016 Article in press: October 24, 2016 Published online: February 16, 2017 Processing time: 226 Days and 13.6 Hours
Abstract
We present a rare case of fecaloma, 7 cm in size, in the setting of systemic scleroderma. A colonoscopy revealed a giant brown fecaloma occupying the lumen of the colon and a colonic ulcer that was caused by the fecaloma. The surface of the fecaloma was hard, large and slippery, and fragmentation was not possible despite the use of various devices, including standard biopsy forceps, an injection needle, and a snare. However, jumbo forceps were able to shave the surface of the fecaloma and break it successfully by repeated biting for 6 h over 2 d. The ability of the jumbo forceps to collect large mucosal samples was also appropriate for achieving fragmentation of the giant fecaloma.
Core tip: A fecaloma can potentially cause intestinal obstruction or perforation. Reduced colonic peristaltic activity is present in systemic scleroderma and can lead to the formation of fecalomas, which are typically treated by surgery. Jumbo forceps, which have larger cups than standard capacity biopsy forceps, can collect large samples and have increased efficacy in diagnosis. To the best of our knowledge, this is the first case report of fecaloma cured by endoscopic fragmentation with jumbo forceps.
