A Long History of Constipation

摘要

An otherwise healthy 64-year-old male presented to the emergency department with a 2-month history of constipation and tenesmus. He had seven admissions in the emergency department within the last 6 weeks and was already under laxative therapy, but it was ineffective. His physical examination was unremarkable, except for dehydration and diffuse abdominal pain. Blood tests demonstrated a mildly elevated serum creatinine. Abdominal radiography was performed and documented severe fecal impaction (Fig. ). Computed tomography confirmed the presence of a fecal impaction with marked compression of the abdominal viscera, including the bile ducts, without signs of colonic perforation (Fig. ). After rehydration, the patient underwent manual disimpaction under general anesthesia. His recovery was unremarkable.