Abstract:An 83-year-old woman with oral corticosteroid use for chronic autoimmune conditions presented with abdominal pain and constipation for the previous seven days. CT of the abdomen and pelvis revealed a large fecaloma with diffuse pneumatosis involving the retroperitoneum, subcutaneous tissue, and mediastinum. An emergent exploratory laparotomy revealed perforation of the rectum below the peritoneal reflection into the retroperitoneum. An end-colostomy with Hartmann's operation was then performed intra-operativel… Show more
“…Her Clozapine was suspended for several days due to her neutropenia. She was given G-CSF to improve her neutropenia to improve her chances of survival as it known that immunocompromised patients with sepsis have worse prognosis [ 9 ]. Fortunately, the patient recovered well post-operatively and was discharged to rehabilitation on day 10.…”
Stercoral perforation is a rare but life-threatening condition that is increasingly being recognised as a sequelae of severe constipation. We present the case of a 45-year-old female who presented with stercoral perforation secondary to severe constipation related to adjuvant chemotherapy for colorectal cancer on a background of long-term antipsychotic medications. Chemotherapy-induced neutropaenia posed an additional treatment consideration in the management of sepsis associated with stercoral perforation. This case demonstrated that the morbidity and mortality from constipation especially in at risk patients cannot be underestimated.
“…Her Clozapine was suspended for several days due to her neutropenia. She was given G-CSF to improve her neutropenia to improve her chances of survival as it known that immunocompromised patients with sepsis have worse prognosis [ 9 ]. Fortunately, the patient recovered well post-operatively and was discharged to rehabilitation on day 10.…”
Stercoral perforation is a rare but life-threatening condition that is increasingly being recognised as a sequelae of severe constipation. We present the case of a 45-year-old female who presented with stercoral perforation secondary to severe constipation related to adjuvant chemotherapy for colorectal cancer on a background of long-term antipsychotic medications. Chemotherapy-induced neutropaenia posed an additional treatment consideration in the management of sepsis associated with stercoral perforation. This case demonstrated that the morbidity and mortality from constipation especially in at risk patients cannot be underestimated.
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