Purpose: Fecal impaction is a common condition, and " fecaloma" is an extreme variety of impaction. This is a report of a giant, solitary, and stubborn fecaloma not responding to nonoperative management. A surgical intervention for uncomplicated fecal impaction is rarely needed and reported in the literature.
Method: A 39-year-old male patient with constipation presented with a firm, mobile, abdominal mass of six-months duration. Investigations revealed an isolated, giant fecaloma in a redundant sigmoid megacolon. After all the conservative measures were unsuccessful in evacuating the stubborn impaction, he was treated by sigmoid colectomy and primary anastomosis.
Conclusion: A timely surgical intervention in recalcitrant fecal impactions may prevent possible stercoral ulcer perforation with a high mortality.