Abstract
Faecal impaction (stercoroma) is an uncommon but serious cause of large bowel obstruction (LBO) in the adolescent population. We report a rare case of a 16‑year‑old boy with longstanding constipation who developed a closed‑loop LBO secondary to a massive stercoroma. The patient presented with abdominal distension, respiratory distress, and haemodynamic instability. Imaging revealed marked colonic dilatation due to obstructing faecal matter and a competent ileo-caecal valve. Despite initial attempts at rectal evacuation, surgical intervention was required. A Hartmann's procedure with decompression and resection of megacolon was performed successfully. This case highlights the importance of early recognition and timely surgical management of stercoroma‑related LBO in young patients.