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Abdominal compartment syndrome secondary to megarectum and megasigmoid
  1. Mohamed Awad Zarog1,2,
  2. Donal Peter O’Leary1,
  3. Kirk J Levins1,
  4. Gerard John Byrnes1,2
  1. 1 Department of Surgery, University Hospital Limerick, Limerick, Ireland
  2. 2 Graduate Entry Medical School, University of Limerick, Limerick, Ireland
  1. Correspondence to Mr Mohamed Awad Zarog, mohamedzarog2000{at}


A 31-year-old male patient with chronic constipation of unknown aetiology presented emergently with worsening nausea, vomiting and abdominal distension of one week duration. On examination, his abdomen was distended with minimal tenderness. A plain film of the abdomen demonstrated severe faecal loading. The patient was haemodynamically unstable on admission and appeared sick. An urgent CT abdomen and pelvis was conducted showing extensive rectal dilatation and associated proximal colonic stercoral perforation. The patient proceeded straight to theatre for laparotomy as his general condition was deteriorating rapidly. On transfer to the operating table, the patient suffered cardiopulmonary arrest. Resuscitation was immediately commenced. Abdominal compartment syndrome was suspected. Cardiac output was re-established following a midline laparotomy which acted relieve the abdominal pressure. The rectosigmoid faecal content was decompressed via an enterotomy. The perforated segment of transverse colon was resected and an end colostomy fashioned. A year later, the continuity of the bowel was re-established.

  • gastrointestinal surgery
  • general surgery

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  • Contributors This case report was written by MAZ with input from DPO’L and KJL and edited by GJB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.