title: 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.
authors.affiliation: Maidstone & Tunbridge Wells NHS Trust, Tunbridge Wells, UK.
authors.forename: David Samuel
authors.initials: DS
authors.lastname: Starnes
authors.affiliation: Maidstone & Tunbridge Wells NHS Trust, Tunbridge Wells, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Lawrence
authors.affiliation: Maidstone & Tunbridge Wells NHS Trust, Tunbridge Wells, UK.
authors.forename: Ragavan
authors.initials: R
authors.lastname: Navaratnam
mesh_terms: D000005:Abdomen / Q000098:blood supply / Q000473:pathology*; D003248:Constipation / Q000150:complications*; D017809:Fatal Outcome; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007420:Intestine, Large / Q000098:blood supply / Q000473:pathology*; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012039:Regional Blood Flow; D012151:Resuscitation; D014682:Vena Cava, Inferior
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