Mega colon Secondary to Chronic Constipation
Matthew Schultzel, Tom Arnold, Marcella Fornari and Maurizio Miglietta
World Journal of Medical and Surgical Case Reports 2013, 2:11
Constipation as a cause of mega-colon is rare. We describe a case of a 46 year old patient who developed mega-colon secondary to severe constipation. The patient had circulatory collapse secondary to cardiogenic shock and possibly intra-abdominal hypertension. The present (not a study) describes the diagnosis and treatment of mega-colon secondary to chronic constipation in a 46 year old patient. A CT scan revealed a massive dilated colon that was compressing the patient’s vena cava. Subsequently, the patient was in cardiogenic shock and suffered an MI. The patient exhibited symptoms of cardiogenic shock with pressures dropping to 64/48 requiring dopamine. An EKG demonstrated inferolateral ischemia, with TI initially 0.2, CK 79, and CKMB 1.7. The patient was admitted to the ICU. While in the ICU, the patient was intubated, sedated, and manually dis-impacted as he was unstable for operative intervention. Post procedure, a KUB was obtained showing less dilation of the colon and no free air. The physical exam was much improved and the patient was being weaned off pressure support. An echocardiogram was performed and demonstrated poor visibility of the left ventricle with an estimated ejection fraction of 60%. His cardiac enzymes were being trended resulting in TI of 0.89, CK 136, CKMB 10.9, Lactate 1.2, pH 7.14. Twelve hours later the patient suffered a massive MI, and expired with TI 11.2, CK 515, CKMB 59.3, and lactate 13.7.