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- W2520522676 abstract "An 18-year-old man was admitted to the emergency department with abdominal pains and gradually worsening weakness. His medical history included mild asthma and chronic constipation. His only treatment was on-demand inhalation of salbutamol. The clinical examination revealed neither fever nor hemodynamic instability but a distended and incompressible abdomen and a white and painless right lower limb edema. The patient's leg pulses were present. No elevated lactic acid, electrolytic abnormality, or renal dysfunction were observed. Right lower limb thrombosis was ruled out by vascular sonography. Contrast-enhanced abdominal and pelvic computed tomography scans revealed a voluminous fecal impaction without any signs of perforation (Figure 1). Interestingly, this fecaloma was also responsible for a compression of both the right ureter (Figure 2) and the right lateral iliac vessels (Figure 3). After the patient refused medical laxative treatment, the fecal impaction was manually drained off under general anesthesia. After disimpaction, the lower limb edema gradually resolved without further management. Six months later, a normal anorectal manometry disproved the hypothesis of a late diagnosis of Hirschsprung's disease. Figure 2Axial contrast-enhanced abdominopelvic computed tomography scan at the portal venous phase. (A) Right pelvicalyceal dilatation (arrow). (B) Distension of the right ureter (arrow). View Large Image Figure Viewer Download Hi-res image Figure 3Axial contrast-enhanced pelvic computed tomography scan at the portal venous phase, focusing on the compression of the right iliac vein (white arrow) in comparison with left side (black arrow). View Large Image Figure Viewer Download Hi-res image" @default.
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- W2520522676 date "2017-01-01" @default.
- W2520522676 modified "2023-10-03" @default.
- W2520522676 title "Threatening Fecal Impaction" @default.
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- W2520522676 doi "https://doi.org/10.1016/j.jemermed.2016.07.009" @default.
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