Fecal material

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Fecal material, also fecal matter, is poo. It is seen in gastrointestinal pathology.

Fecal material
Diagnosis in short

A food particle and a tubular adenoma. H&E stain.

LM plant matter - has cell walls, meat - skeletal muscle without nuclei, microorganisms (bacilli, cocci), +/-colorectal mucosa
LM DDx necrosis
Gross soft material, amorphous, friable
Site cecum, colon, rectum

Clinical history poor bowel preparation
Clin. DDx gastrointestinal polyp

General

  • Common.
  • Associated with poor bowel preparation.
    • People on a low-fibre diet seem to have less of 'em.[1]
  • Endoscopists go after anything that is polypoid and that may be nothing more than poo.

Gross

  • Soft amorphous material.
  • +/-Friable.

Microscopic

Features:

  • Plant material:
    • Yellow staining chicken wire-like material - may be linear.
      • Thick cell walls often without cytoplasm and usually without a nucleus.
  • Meat:
    • Essentially ischemic skeletal muscle without inflammation.
      • Eosinophilic material without nuclei and without inflammation.
        • Honeycomb-like when fibres seen in cross-section.
  • +/-Microorganisms.
  • +/-Inflammatory cells.

DDx:

Images

Sign out

  • Often ignored if colorectal mucosa is present.
TRANSVERSE COLON, BIOPSY:
- FECAL MATERIAL.
- NO DEFINITE COLONIC MUCOSA IDENTIFIED.

Alternate

ASCENDING COLON ("POLYP"), REMOVAL:
- CONSISTENT WITH PARTIALLY DIGESTED FOOD.
- NO DEFINITE COLONIC MUCOSA IDENTIFIED.

Micro

The sections show a fragment of striated muscle without nuclei and without inflammation, with scant microorganisms. No colorectal mucosa is identified.

Rectum

RECTUM, BIOPSY:
- FECAL MATERIAL.
- NO DEFINITE RECTAL MUCOSA IDENTIFIED.

References

  1. Liedenbaum, MH.; Denters, MJ.; de Vries, AH.; van Ravesteijn, VF.; Bipat, S.; Vos, FM.; Dekker, E.; Stoker, J. (Jul 2010). "Low-fiber diet in limited bowel preparation for CT colonography: Influence on image quality and patient acceptance.". AJR Am J Roentgenol 195 (1): W31-7. doi:10.2214/AJR.09.3572. PMID 20566777.

See also