Journal of Ultrasound in Medicine, Vol 4, Issue 11 573-575, Copyright © 1985 by American Institute of Ultrasound in Medicine
Sonographic appearance of fecal masses
L. E. Derchi, F. Musante, E. Biggi, G. R. Cicio and L. Oliva
Fecal impaction, caused by incomplete evacuation of feces over an extended
length of time, may lead to the formation of a fecaloma, a large, firm mass
of stool. Sonography is commonly used as the first imaging procedure in
patients presenting with abdominal masses. In the five cases cited,
fecaloma was suspected by sonography in four cases; confirmation was
obtained by rectal examination in three cases and by radiographic studies
in two cases. A representative case report is presented of a 74-year-old
woman who had a large pelvic mass detected on physical examination.
Sonographically, the fecaloma had a highly echogenic surface and a
posterior acoustic shadow. Radiographic examination showed a "soap bubble"
appearance, suggestive of stool. Thus, fecaloma should be considered in the
differential diagnosis of patients with highly reflective and shadowing
abdominal and/or pelvic masses.
