Imaging for Fecal Impaction

Initial Imaging Approach

• The American College of Radiology recommends standard CT abdomen/pelvis with IV contrast when vascular complications or inflammatory processes are suspected, and non-contrast CT may be sufficient for simple fecal impaction diagnosis, though contrast helps evaluate for complications 1

Specialized Imaging Modalities

• The American College of Radiology suggests that barium enema is contraindicated in the setting of suspected or confirmed bowel perforation due to risk of severe chemical peritonitis 2
• MR defecography with rectal contrast can identify structural abnormalities contributing to chronic constipation and recurrent fecal impaction, such as rectoceles, internal prolapse, or pelvic floor dyssynergia, according to the Journal of the American College of Radiology 3, 4