Stercoral perforation, which is a colonic perforation secondary to impacted stool, is a rare but highly mortal clinical entity. The main pathophysiology is chronic inflammation, ischemia caused by chronic pressure, necrosis, and subsequent perforation. The major risk factors are being older, chronic constipation, immobilization, being bedridden, and comorbidities that cause constipation and prolonged colonic transition. The most common clinical findings are abdominal pain, acute abdominal tenderness, and sepsis symptoms. We present two cases of stercoral perforation whose postoperative clinical courses varied significantly due to differences in perforation sites and the degree of intra-abdominal contamination. Accurate diagnosis of stercoral perforation is vital for physicians to implement timely and effective interventions, ultimately reducing morbidity and mortality through early detection.

Keywords: Stercoral perforation, stercoral colitis, cecum perforation, sigmoid colon perforation, fecal impaction