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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 59-year old man&#44; institutionalized with depressive and nutritional disorders due to gastrostomy&#44; was admitted to the nephrology office for renal function impairment that started a year ago&#44; which coincided with an episode of urinary retention that required catheterization&#46; The catheter was subsequently withdrawn after the symptoms resolved&#46; During the current check-up&#44; the patient presented obvious signs of dehydration with a worsening glomerular filtration rate&#58; creatinine&#44; 4&#46;24<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; urea 307<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; Chronic Kidney Disease Epidemiology Collaboration equation &#40;CKD-EPI&#41;&#44; 14&#46;3<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#59; sodium&#44; 157<span class="elsevierStyleHsp" style=""></span>mEq&#47;L&#59; and potassium&#44; 5&#46;1<span class="elsevierStyleHsp" style=""></span>mEq&#47;L&#46; The ultrasound revealed grade 3 bilateral ureterohydronephrosis&#59; the patient was therefore referred to the urology department for an urgent evaluation&#46; The emergency department performed abdominal computed tomography&#44; which revealed a giant fecaloma in the rectosigmoid &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; which caused extrinsic ureteral compression &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; resulting in acute renal failure due to obstruction&#46; The patient underwent conservative management with serotherapy&#44; laxatives and enemas&#44; as well as manual disimpaction&#44; which resulting in abundant stools and improvement of the symptoms and associated parameters&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Although extremely rare&#44; fecal impaction should be considered in the differential diagnosis of acute obstructive renal failure&#44; taking special care with elderly patients&#44; patients with diabetes&#44; those with psychiatric disorders and those polymedicated with opioids&#44; antidepressants&#44; anticholinergics or antipsychotic agents&#46; Most cases involve banal conditions that are resolved with conservative treatment&#44; although they occasionally constitute a medical&#8211;surgical emergency&#46;</p></span>"
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Medicine in Image
DOI: 10.1016/j.rceng.2018.10.011
Fecaloma as a cause of acute renal failure
Fecaloma como causa de fracaso renal agudo
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E. Hernández Garcíaa,
Corresponding author
elena_46hg@hotmail.com

Corresponding author.
, M.J. Torres Sáncheza, J. Gómez Sánchezb
a Servicio de Nefrología, Hospital Universitario San Cecilio, Granada, Spain
b Servicio de Cirugía General, Hospital Universitario San Cecilio, Granada, Spain

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