Colonic Obstruction Resulting from Fecalith in Patients with Scleroderma

The gastrointestinal manifestations of scleroderma are believed to result from a loss of intrinsic neural circuits followed by smooth muscle atrophy and patchy fibrosis.1 Fibrous proliferation in the muscularis propria and submucosal vessels along with atrophy of the muscular wall of the colon result in impaired colonic motility. Because of worse outcomes associated with stercoral complications,3 it is imperative to identify colonic obstruction resulting from a fecalith early in its course and to continue treatment until complete evacuation has been achieved.4 Patients with scleroderma may be predisposed to these complications because of the pathophysiological consequences of their disease.