Psychiatric drug–induced fatal abdominal compartment syndrome

Jambet, Sophie; Guiu, Boris; Olive-Abergel, Pierre; Grandvuillemin, Aurélie; Yeguiayan, Jean-Michel; Ortega‐Deballon, Pablo

doi:10.1016/j.ajem.2011.01.005

Cited by 6 publications

(1 citation statement)

References 5 publications

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“…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. Clozapine is effective for treatment-resistant schizophrenia but is prescribed uncommonly (66.7 per 100,000 persons in the 2010 Medicaid database).…”

Section: Discussionmentioning

confidence: 99%

Fatal Abdominal Compartment Syndrome Due to Constipation: A Case Report

Kongkatong

Patel

Thom

et al. 2022

Clinical Practice and Cases in Emergency Medicine

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Introduction: Abdominal compartment syndrome (ACS) is a rare condition in which increased intra-abdominal pressure causes multiorgan dysfunction through decreased perfusion. Causes of this condition are variable, and early recognition is critical for favorable patient outcomes. Measurement of bladder pressure is recommended for diagnosis. Case Report: A 64-year-old female on clozapine with a two-year history of chronic constipation presented to the emergency department in extremis with a protuberant abdomen. After resuscitative measures, computed tomography showed a dilated, stool-filled colon with a decompressed inferior vena cava and decreased perfusion. She died despite surgical decompression. Conclusion: Severe constipation is a rare cause of ACS, and there is a lack of evidence-based guidelines. Options for bedside decompression are limited. To reduce morbidity and mortality in this population, early recognition of ACS is imperative. Initial interventions should support hemodynamics and respiration. Definitive management is surgical decompression.

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Section: Discussionmentioning

confidence: 99%