Radiologically Striking Colonic Fecal Impaction Due to Date Pit Ingestion in a Psychiatric Patient: A Case Report

Maryam  Soheilipour; Hoda  Imani; Elham  Tabesh

doi:10.18502/crcp.v10i4.21112

Maryam Soheilipour Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Hoda Imani Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Elham Tabesh Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

DOI: https://doi.org/10.18502/crcp.v10i4.21112

Keywords: Fecal impaction; Date pits; CT imaging, Bezoar; Psychiatric patient

Abstract

Fecal impaction is a frequent complication in elderly and neuropsychiatric populations,often due to multifactorial causes such as impaired motility, medication side effects,and behavioral abnormalities. In rare instances, ingestion of indigestible material, suchas date pits, can lead to obstructive fecal loading. We report a 54-year-old womanwith bipolar disorder and schizophrenia who presented with abdominal pain andconstipation lasting three days. Laboratory findings were unremarkable, except for anelevated ESR. Imaging studies, including plain abdominal radiographs and abdominalultrasound, showed no clear signs of obstruction but revealed colonic fecal loading.A CT scan without contrast demonstrated marked colonic dilatation and multiplehyperdense intraluminal foreign bodies, consistent with date pits. Upon questioning,the patient confirmed excessive ingestion of whole dates. Conservative managementwith enemas led to successful resolution, and the patient passed stool containingnumerous intact date pits. Unusual causes of fecal impaction should be consideredin at-risk populations, particularly psychiatric patients with erratic dietary behaviors.Recognizing the CT signature of ingested date pits is essential for accurate diagnosisand timely, conservative management.