Clozapine-induced stercoral colitis: a surgical perspective

Abstract

We describe a case of a 46-year-old man with schizophrenia treated with clozapine who presented as an emergency with abdominal pain on the background of a 1 month history of constipation. The initial presenting symptoms were vague and a diagnosis was difficult to establish. Initial CT of the abdomen and pelvis demonstrated only minor abnormalities. He continued to deteriorate until a further CT scan revealed worsening stercoral colitis. He subsequently underwent an emergency total colectomy and ileostomy formation and had a complicated prolonged postoperative recovery. This case highlights the risks that clozapine can have on slowing bowel transit and the dangerous consequences that can occur if not identified early.

Non-perforated Stercoral Colitis patients with septic shock have a higher mortality than their perforated counterparts. A case report and review of literature

“…Within the individual case reports were 13 cases of PSC with 3 fatalities [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] . There were 9 cases total of NPSC with 4 fatalities [4] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] . When the NPSC cases were stratified for sepsis, a total of 4 cases with 2 fatalities was yielded [24] , [25] , [26] , [27] .…”

“…There were 9 cases total of NPSC with 4 fatalities [4] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] . When the NPSC cases were stratified for sepsis, a total of 4 cases with 2 fatalities was yielded [24] , [25] , [26] , [27] .…”

“…When combining the cases of NPSC with sepsis from the case series published by Saksonov et al and Cheng Wu et al, with individual case reports [24] , [25] , [26] , [27] there was a total of 11 cases. Our case would make the 12th such case in the literature.…”

Stercoral Colitis in a Patient With Pediatric-Onset Systemic Lupus Erythematosus: Case Analysis and Review of the Literature

“…Although there is a reports that ischemia colitis is associated with antiphospholipid syndrome ( 24 ), but reviewing her 20-year history of lupus, no antiphospholipid antibodies were found. In addition, it is reported that some anticonvulsants can induce stercoral colitis ( 25 ), but only one short-term benzodiazepines was used 9 year ago to control a seizure. Importantly, we mainly considered the four neurological events (seizure, cranial neuropathy, transverse myelitis, and brain abscess) lead to impaired nerve innervation and cause neurogenic bladder and chronic constipation, which resulted in this catastrophic stercoral colitis.…”

Did we do everything we could have? Nurses’ contributions to medicines optimization: A mixed‐methods study

“…The nursing workforce is divided regarding role expansion, and a care gap has opened, leaving the monitoring of patients for possible ADRs, non‐adherence and patient education unattended: doctors and nurses each think the other is or should be doing this work, leading to preventable ADRs (Jordan, 2002), sometimes necessitating hospitalization (NICE, 2015; George et al., 2019; Jordan & Hughes, 2019). We identified dissonance in the data: whilst there was consensus that nurses should expand their roles in these domains and tasks, only ~ 50% nurses were willing to do this.…”