Sir,

A fecaloma (even called stercoroma, coproma or scatoma) is a mass of feces most frequently noted in the rectum and sigmoid colon, and is considered a severe/extreme form of fecal impaction.

Symptoms are non-specific and include constipation, abdominal pain, anorexia, nausea, vomiting, overflow diarrhea, fecal incontinence and urinary symptoms from pressure.

Usually, the fecal matter accumulates in the intestine, then stagnates and increases in volume until the intestine becomes deformed and acquires characteristics similar to those of a tumor.

Faecal concretions or faecalomas („stone of faeces”) are symptomatic of many well-recognised colorectal conditions. Faecalomas are usually located in the colon or rectum and associated with disorders of colorectal transit.

Faecaloma in ano is always correlated with chronic anal fissures and chronic constipation: that alternatively and intermittently appear and disappear: two are the main strategies to attempt to mantain the conditions static and to avoid the complicances of infective and inflammatory sequences may develop and risk to let the patient could be assaulted by colon-rectal tumors.

Constipation with faecal impaction is a common condition, which may lead to serious potential complications [1]. Among such complications, the putrefation, rot and severe itching, redness, excoriations and abrasion in ano (inflammation and infection) due to the spillage and leak of suppurative pus (thick, opaque, usually yellowish white fluid matter formed in association with inflammation caused by the invasion of the body by infective microorganisms (such as bacteria). It is composed of degenerating white blood cells as leukocytes, tissue debris, and living or dead microorganisms) rich in butyrrhic and isopropionic acids that irritates the circumstantial region of the anal foramen.

In order to treat this dermatological dramatic conditio, one may assert that this paper has been conceived by the three AA:

-the third A is the victim of this complication due to a giant fecolaoma that involves the copresence of fissures and fistulae in the area surronding the anal formanen;

-the second A provided a natural salbe apt to absorb and cure the inflammation and infection, in order to disminish the redness and strong itching.

-the corresponding A is the one who suggested all the strategies and advices to mantain a perfect intimate hygiene in the injured area of the body of the third A.

MATERIALS AND METHODS

A salbe has been created on purpose by the second A and the formula is the following:

panthenol; talc des Pyrenees; allantoin; Magnesium sulfate; Copper sulfate; Vitamin H; Zinc oxide

Butyrospermum parkii butter; Almond oil; Olive oil; Melia azadirachta oil; 18-b glycerrhetic acid; Chlotrimazol; Phytic acid; Chlorexidine digluconate; Bisabolol; Vitamin E; Organic squalane; Zanthalene; Ceramides [2–6].

Where each of every ingredient of the emplastrum presents a specific activity:

-talc is apt to absorb the liquid suppurative pus

-glycerrhetic acid and chlorexidine have been chose to defeat the bacterial assault

Melia azadirachta oil and chlotrimazol are useful to combat yeasts and so the inflammatory conditio of the skin and external mucosa of anus

Bisabolol, Vitamin E, Almond and Olive oil have been selected for their lenitive and apaisant precious ability

And even natural squalane permits to mantain hydration and nourishment of the injured zone.

The paste (or emplastrum or ointment9 had to be spread before to go to bed or at morning early.

RESULTS

The restitutio ad integrum is very slow and during the treatment the third A wore diapers to avoid pus to stain clothing during working activities, but 30 days have been sufficient to observe a real healing and recuperation.

The strategies for an optimal intimate hygiene, contributed by the corresponding A, were douching with tepid vervain water, spreading a mix of of acajou oil and marigold glyceric extract after every evacuation.

REFERENCES

Notes