SYMPTOMS OF A CLOGGED COLON. A-Z

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Story of A TOXIC MEGA-COLON

A 66 year old chronic schizophrenic who lived in a nursing home was brought to the emergency department with the chief complaint of constipation, along with diffuse abdominal pain and shortness of breath. His nursing home records indicated that he had a vigorous appetite, despite not having had a bowel movement for more than a month.

Within minutes of presentation, the patient became lethargic and unresponsive and was subsequently incubated. His rectal temperature was 102º f and his white blood cell count was 22,000/mm³. He had a ventral hernia, his abdomen was extremely distended without bowel sounds, and a plain film of the abdomen revealed absence of air in the right colon. In the operating room, a large, ischemic, dilated loop of bowel was removed. The patient died 3 days later of fulminant sepsis.

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Reprinted by permission from HOSPITAL MEDICINE, 12-1995

Originally Submitted by Carl K. Hsu, MD-Cheif Resident -Mt Sinai School of Med.