{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T10:50:48Z","timestamp":1782384648110,"version":"3.54.5"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Stapled hemorrhoidopexy (SH) is used for prolapsing hemorrhoids and is associated with less short-term postoperative pain. While constipation is common after SH, proximal sigmoid fecaloma is rarely reported. We report a 49-year-old woman who presented with severe abdominal pain and obstipation 14\u00a0days after SH. Although digital rectal examination revealed an empty rectum, computed tomography (CT) demonstrated a large fecaloma in the proximal sigmoid colon, 15\u00a0cm proximal to the intact staple line. A rectal tube enema failed, but a targeted high enema via flexible sigmoidoscopy achieved partial softening, followed by successful evacuation with nasogastric polyethylene glycol irrigation. This case highlights that an empty rectum on digital examination does not exclude proximal fecal impaction after SH. Early CT may help differentiate proximal fecaloma from staple-line complications and support stepwise nonoperative management in selected stable patients.<\/jats:p>","DOI":"10.1093\/jscr\/rjag453","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:46:17Z","timestamp":1779277577000},"source":"Crossref","is-referenced-by-count":0,"title":["Proximal sigmoid fecaloma after stapled hemorrhoidopexy: a diagnostic pitfall and stepwise nonoperative management"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9928-1209","authenticated-orcid":false,"given":"Myung Jae","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Surgery , Daehang Hospital, 2151, Nambusunhwan-ro, Seocho-gu, Seoul 06699 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6730-5015","authenticated-orcid":false,"given":"Jaewon","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Surgery , Daehang Hospital, 2151, Nambusunhwan-ro, Seocho-gu, Seoul 06699 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"2026062506234943200_ref1","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1016\/S0140-6736(16)31803-7","article-title":"Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial","volume":"388","author":"Watson","year":"2016","journal-title":"Lancet"},{"key":"2026062506234943200_ref2","doi-asserted-by":"publisher","first-page":"44","DOI":"10.9738\/INTSURG-D-13-00173.1","article-title":"Documented 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and gastrointestinal transit time: a meta analysis","volume":"296","author":"Muller-Lissner","year":"1988","journal-title":"BMJ"},{"key":"2026062506234943200_ref6","doi-asserted-by":"publisher","first-page":"6","DOI":"10.4240\/wjgs.v10.i2.6","article-title":"Dolichocolon revisited: an inborn anatomic variant with redundancies causing constipation and volvulus","volume":"10","author":"Raahave","year":"2018","journal-title":"World J Gastrointest Surg"},{"key":"2026062506234943200_ref7","first-page":"33","article-title":"A case of colonic fecal impaction caused by excessive dietary fiber intake that was endoscopically treated with intra-fecal injection of a bowel-cleansing agent","volume":"9","author":"Kawabata","year":"2023","journal-title":"J Clin Transl Res"},{"key":"2026062506234943200_ref8","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1007\/s00384-005-0784-8","article-title":"Complications and reoperations in stapled anopexy: learning by doing","volume":"21","author":"Jongen","year":"2006","journal-title":"Int J Color Dis"},{"key":"2026062506234943200_ref9","doi-asserted-by":"publisher","first-page":"441","DOI":"10.3949\/ccjm.70.5.441","article-title":"Fecal incontinence in elderly patients: common, treatable, yet often undiagnosed","volume":"70","author":"Stevens","year":"2003","journal-title":"Cleve Clin J Med"}],"container-title":["Journal of Surgical Case 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