Abstract
Stercoral colitis is a rare but serious condition characterized by inflammation of the colonic mucosa due to impacted and hardened faecal material. The word "stercoral" means "related to faeces". This condition usually develops due to the accumulation of hard stool masses in the colon, which cause localized inflammation and irritation. These faecalomas can exert persistent pressure on the colonic wall, causing damage and inflammation. Stercoral colitis presenting symptoms that mimic acute mesenteric ischemia is a diagnostic challenge for clinicians due to the overlap in clinical manifestations. Changes in bowel habits, bloating, and excruciating abdominal pain are potential manifestations of both illnesses, making it difficult to distinguish between them using clinical presentation. Diagnostic imaging, such as computed tomography scans, significantly discriminates between stercoral colitis and acute mesenteric ischemia. In cases where stercoral colitis mimics acute mesenteric ischemia, a thorough evaluation is essential to rule out vascular compromise. Timely and accurate diagnosis is crucial, as the management strategies for these two conditions differ significantly. Stercoral colitis often requires bowel evacuation and addressing the underlying faecal impaction. Acute mesenteric ischemia demands prompt vascular intervention to restore blood flow and prevent severe complications like bowel infarction. Given the potential overlap in symptoms and the critical importance of distinguishing between stercoral colitis and acute mesenteric ischemia, a multidisciplinary approach involving radiological imaging, clinical expertise, and timely intervention is essential for optimal patient care. This case highlights the importance of considering stercoral colitis when evaluating a patient with an acute abdomen, especially elderly patients with history of constipation. LEARNING POINTS: Constipation is a common condition that can lead to serious complications, especially in older people, and should be addressed as soon as possible.Early recognition of stercoral colitis and appropriate treatment can prevent critical consequences.Stercoral colitis can induce bowel ischemia, causing acute abdominal pain mimicking acute mesenteric ischemia.