Massive faecal impaction leading to abdominal compartment syndrome and acute lower limb ischaemia

Ho, Simon; Krawitz, Russel; Fleming, Bill

doi:10.1136/bcr-2018-225202

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…If untreated, ACS can lead to multisystem organ failure and death, with nearly 100% mortality [1]. Additionally, ACS associated with new organ dysfunction or failure has a mortality rate of up to 60%, and despite many efforts, mortality in patients with ACS remains unacceptably high [1,2,8,22]. The key to optimizing outcome is early abdominal closure within 7 days, because failure to do so increases morbidity, mortality, and fistula formation [8,17].…”

Section: Discussionmentioning

confidence: 99%

“…ACS was first reported in 1984, and its pathophysiology was described as resulting from IAH [2]. ACS is defined as a sustained raised level of intra-abdominal pressure (IAP) more than 20 mmHg with or without abdominal perfusion pressure less than 60 mmHg and the development of new end-organ failure; its reported risk factors are shown in Table 1 [3][4][5][6][7][8][9]. Among these, there are several reports of ACS associated with or caused by fecal impaction [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Abdominal compartment syndrome due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy: a case report and review of the literature

et al. 2020

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Background Abdominal compartment syndrome (ACS) is defined as a sustained raised level of intra-abdominal pressure more than 20 mmHg with or without abdominal perfusion pressure less than 60 mmHg and the development of new end-organ failure. Abdominal surgery, major trauma, volvulus, ileus, distended abdomen, fecal impaction, acute pancreatitis, liver dysfunction, sepsis, shock, obesity, and age have all been reported as risk factors. Herein, we report the severest known case of ACS due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy, together with a brief review of the literature. Case presentation A 48-year-old Asian man suffering from shock was transported by ambulance to our hospital. His medical history included hypoglycemic encephalopathy sequelae, disuse syndrome, type 2 diabetic neuropathy, and constipation. He recovered consciousness in the ambulance, and his physical examination as well as laboratory findings were normal. X-ray and dynamic computed tomography revealed a thickened gut wall, and an extremely dilated sigmoid colon and rectum filled with a massive amount of stool as well as gas, compressing other intra-abdominal organs. We diagnosed the patient with transient vasovagal syncope, together with ACS, due to extremely elongated sigmoid colon and rectum plus fecal impaction, caused by anorectal disturbance derived from disuse syndrome and diabetic neuropathy. We first repeated stool extraction for bowel decompression and he subsequently became symptom-free, after which we performed a colostomy on the 28th hospital day. The postoperative course was uncomplicated, and he was discharged on the 44th hospital day. Conclusions Clinicians need to keep ACS in mind as a differential diagnosis and perform careful and detailed examination when encountering patients presenting with symptoms or risk factors of ACS. In addition, they need to precisely diagnose ACS and perform optimal treatment without delay.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Abdominal compartment syndrome due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy: a case report and review of the literature

et al. 2020

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“…One of the major causes of acute limb ischaemia is thrombosis in a pre-existing atherosclerotic arteries 3. Extrinsic compression onto the limb vessels resulting in acute limb ischaemia is a very rare phenomenon with only few reported cases in the literature 4–7…”

Section: Introductionmentioning

confidence: 99%

Acute lower limb ischaemia secondary to aortic compression from uterine fibroid

Nawawi,

Wan Ibrahim,

Yahya

et al. 2023

BMJ Case Rep

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A woman in her early 50s with uncontrolled diabetes mellitus and a huge uterine fibroid presented to the emergency department with diabetic ketoacidosis and bilateral acute lower limb ischaemia. Vascular and advanced imaging studies confirmed distal aortic compression by a huge uterine fibroid, resulting in extensive lower limb arterial thrombosis. After resuscitation, the patient underwent emergency hysterectomy, thromboembolectomy and amputation of the right leg. She remained critically ill and died of fulminant sepsis and multiorgan failure 10 days later. This case reports the effects of external vascular compression by a large pelvic mass.

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An unusual case of abdominal compartment syndrome from a massive faecaloma

Chuang

Lim

Cooper

et al. 2022

Journal of Surgical Case Reports

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Severe constipation is a frequent presentation but progression into a life-threatening acute compartment syndrome (ACS) is few and far between. This case highlights the typical physiological manifestations of ACS and the immediate benefits of correcting these physiological imbalances through the disimpaction of a massive faecaloma. Furthermore, in adult patients with a history of colonic dysmotility, adult Hirschsprung’s disease should be considered.

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Massive faecal impaction leading to abdominal compartment syndrome and acute lower limb ischaemia

Cited by 4 publications

References 4 publications

Abdominal compartment syndrome due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy: a case report and review of the literature

Abdominal compartment syndrome due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy: a case report and review of the literature

Acute lower limb ischaemia secondary to aortic compression from uterine fibroid

An unusual case of abdominal compartment syndrome from a massive faecaloma

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