Background: Stercoral perforation of the colon is a rarely reported disease with high mortality rate. Our literature review identified one prior case reported during pregnancy, with mortality in both mother and infant.
Case: A nulliparous female presented at 36 weeks of gestation with fever, tachycardia, and severe abdominal pain. She delivered by cesarean when purulent ascites and stercoral perforation of the sigmoid colon were discovered. After a sigmoid resection with end colostomy, she and her infant recovered uneventfully.
Conclusion: Stercoral perforation of the colon is rare in pregnancy. Prompt surgical treatment is necessary. Surgical exploration may be warranted in the pregnant patient with unexplained abdominal pain.