Published online Feb 16, 2017. doi: 10.4253/wjge.v9.i2.91
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
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.