{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:15:39Z","timestamp":1784297739015,"version":"3.55.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T00:00:00Z","timestamp":1726272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Stercoral perforation of the colon is a rare and life-threatening condition caused by pressure necrosis due to fecal impaction. It is commonly associated with chronic constipation, particularly in patients with neurogenic bowel disorders or prolonged opioid use. However, its occurrence in the context of chronic heroin use is rarely reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>We report the case of a 40-year-old male with a 5-year history of heroin abuse who presented with diffuse abdominal pain, vomiting, and cessation of gas and stool passage for 10 days. Physical examination revealed a distended abdomen with generalized tenderness, guarding, and a rectal examination confirmed fecal impaction. Computed tomography (CT) showed massive fecal impaction in the sigmoid colon with pneumoperitoneum, indicating perforation. The patient underwent urgent exploratory laparotomy, revealing two perforations in the sigmoid colon with extensive fecal peritonitis. A segmental resection of the sigmoid colon with colostomy was performed. Postoperatively, the patient required intensive care for septic shock but eventually recovered and was referred to an addiction treatment program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>This case highlights the serious gastrointestinal complications associated with chronic opioid use, particularly heroin. The pathophysiology involves opioid-induced inhibition of gastrointestinal motility, leading to chronic constipation, fecaloma formation, and subsequent perforation. Early recognition and prompt surgical intervention are crucial in managing stercoral perforation, which carries a high mortality rate if delayed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case underscores the importance of recognizing gastrointestinal risks in chronic opioid users, especially heroin, and the need for integrated care strategies to prevent severe complications like stercoral perforation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.110313","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T05:17:22Z","timestamp":1726636642000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Stercoral perforation of the sigmoid colon secondary to chronic heroin use: A case report and a review of the literature"],"prefix":"10.1097","volume":"123","author":[{"given":"Imen","family":"Ben Ismail","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwen","family":"Sghaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saber","family":"Rebii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazi","family":"Manai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayoub","family":"Zoghlami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-130-20260507","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1002\/bjs.1800771204","article-title":"Stercoral perforation of the colon","volume":"77","author":"Serpell,","year":"1990","journal-title":"Br. J. Surg."},{"key":"R2-130-20260507","first-page":"368","article-title":"Stercoral perforation of the sigmoid colon. A case report and brief review of the literature","volume":"32","author":"Falidas,","year":"2011","journal-title":"PubMed"},{"key":"R3-130-20260507","doi-asserted-by":"crossref","first-page":"131","DOI":"10.5056\/jnm23144","article-title":"Opioid-induced constipation: old and new concepts in diagnosis and treatment","volume":"30","author":"Squeo,","year":"2024","journal-title":"J. Neurogastroenterol. Motil."},{"key":"R4-130-20260507","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2016-218875","article-title":"Stercoral perforation of the colon in a heroin addict","author":"Brown,","year":"2017","journal-title":"BMJ Case Rep."},{"key":"R5-130-20260507","first-page":"1","article-title":"A case of stercoral perforation detected on CT requiring proctocolectomy in a heroin-dependent patient","volume":"2016","author":"Seligman,","year":"2016","journal-title":"Case Rep. 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Colon Rectum"},{"key":"R12-130-20260507","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00384-002-0417-4","article-title":"Stercoral perforation of the colon in a heroin addict","volume":"17","author":"Tessier,","year":"2002","journal-title":"Int. J. Color. Dis."},{"key":"R13-130-20260507","first-page":"1","article-title":"Stercoral perforation requiring subtotal colectomy in a patient on methadone maintenance therapy","volume":"2012","author":"Sakharpe,","year":"2012","journal-title":"Case Rep. Surg."},{"key":"R14-130-20260507","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.crad.2010.08.002","article-title":"Imaging manifestations of faecal impaction and stercoral perforation","volume":"66","author":"Kumar,","year":"2011","journal-title":"Clin. 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