Is constipation a trivial matter?

Abstract

Constipation is a common symptom of patients presenting to the emergency department. If poorly managed, it can have significant consequences. A 50-year-old man was admitted to the emergency department following cardiac arrest. His medical history included a diagnosis of cerebral palsy and multiple admissions to hospital with constipation. Clinical examination revealed a grossly distended and tense abdomen. Circulatory supply to the lower limbs was acutely impaired. CT scan revealed massive dilation of the large bowel due to faecal loading with compromised circulation to the lower limbs. Despite aggressive attempts at resuscitation, the patient continued to deteriorate and passed away. On reflection, a diagnosis of abdominal compartment syndrome secondary to severe constipation was made. This case highlights the vigilance required when managing what is often felt to be a trivial complaint and the considerable consequences when there is a failure to do so.

Abdominal Compartment Syndrome Secondary to Constipation in an Adult Patient With Cerebral Palsy

“…He presented to the emergency department in a state of cardiac arrest. The patient eventually demised and this was retrospectively attributed to abdominal compartment syndrome from severe constipation [ 10 ].…”

Fatal Abdominal Compartment Syndrome Due to Constipation: A Case Report

“…Our patient’s presentation was caused by severe constipation. Our literature review identified one case of ACS in an adult caused by constipation likely secondary to neurogenic bowel 8 and two cases thought to be due to clozapine use. 9 Her longstanding constipation was likely due to her medication regimen of clozapine, risperidone, and the anticholinergic medications glycopyrrolate and benztropine.…”