Emergency Laparotomy for Abdominal Compartment Syndrome in a Child due to Chronic Functional Constipation

TL;DR

A 13-year-old boy with chronic constipation due to family stress developed life-threatening abdominal compartment syndrome, requiring emergency surgery.

Contribution

This case highlights the rare association between chronic functional constipation and abdominal compartment syndrome in children.

Findings

Chronic functional constipation in a child can progress to life-threatening abdominal compartment syndrome.

Stressful life events may contribute to severe functional constipation leading to surgical emergencies.

Emergency laparotomy with bowel resection successfully treated the condition in this patient.

Abstract

Abdominal compartment syndrome (ACS) in children is a life-threatening complication with high morbidity and mortality. Stressful life events are among the risk factors of functional constipation (FC) in children. We present a 13-year-old male patient with chronic FC due to parents' separation who presented with a history of FC since infancy and inability to defecate during the last month. On examination, the abdomen was distended and tender. His vital signs revealed elevated blood pressure ≥ 95th percentile according to his age weight and gender. On admission, the patient experienced tonic–clonic seizures refractory to medical therapy. He was intubated and a computed tomography (CT) scan revealed an extensive rectosigmoid bowel dilatation. Despite maximal medical support, his condition worsened. ACS was suspected and confirmed via intravesical measurement of intra-abdominal pressure (IAP). An urgent decompression laparotomy (DL) was performed with resection of the affected bowel. His condition improved postoperatively. This case highlights the extremely rare association between ACS and chronic FC resulting from stressful life events.

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