Images in Clinical Medicine
Severe Constipation
N Engl J Med 2008; 358:e26May 29, 2008
- Article
A 46-year-old man with a history of cerebral palsy presented with difficulty in breathing, which had gradually increased during the previous 2 weeks. He was admitted to the intensive care unit with a diagnosis of sepsis, for which he received intravenous fluids, antibiotics, and mechanical ventilation. Computed tomography of the abdomen showed a severely distended colon with fecal stasis compressing the abdominal organs and elevating the diaphragm. There were no signs of colonic perforation. After initial conservative measures were unsuccessful in evacuating the impaction, multiple enemas with the use of sodium phosphate and soapsuds finally dislodged the blockage after 2 weeks. The patient's recovery was unremarkable.
Gustavo Cumbo-Nacheli, M.D.
Wayne State University School of Medicine, Detroit, MI 48201
gcumbona@med.wayne. edu
