Constipation presenting as respiratory distress.
This case report describes a 14-year-old boy presenting with a barrel-chested appearance and a complaint of shortness of breath on exertion. The patient had a long history of severe constipation with overflow incontinence. Physical examination suggested limited diaphragmatic excursion. Initial pulmonary function studies showed a restrictive pattern. Catharsis resulted in an 11-lb weight loss and normalization of pulmonary function. We speculate that the extrinsic upward pressure imposed on the diaphragm by a full bowel resulted in increased anteroposterior diameter, decreased lung height, and a reversible restrictive pattern on pulmonary function studies.
D000208:Acute Disease; D000293:Adolescent; D003248:Constipation / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000000981:diagnostic imaging; D004688:Encopresis / Q000209:etiology; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis*; D008297:Male; D011859:Radiography