Constipated man gets emergency surgery after his colon bursts

A British man’s worsening battle with constipation ended up costing him part of his gut, due to a rare, sometimes unexplainable condition known as ‘megacolon’

A CT scan taken from the side that shows the man’s colon, filled with faeces, before it burst. Image Courtesy: Patel, et al (BMJ Case Reports)
A CT scan taken from the side that shows the man’s colon, filled with faeces, before it burst.
Image Courtesy: Patel, et al (BMJ Case Reports)

There’s no question that constipation is uncomfortable. But sometimes it can be downright dangerous, as detailed in a paper published in BMJ Case Reports this month. As the report explains, a 24-year-old man’s colon burst from storing too much faeces.

According to the report, the unidentified patient visited the emergency room after experiencing abdominal pain and diarrhoea for seven days. This wasn’t his first visit: over the past four years, the patient had been admitted to the hospital several times due to chronic constipation.

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His rectum had dilated up to 18-cm inside his body and was ‘filled with faeces,’ according to the BMJ case report Image courtesy: BMJ case report

On this occasion, his stomach was bloated and tender, and a CT scan showed his rectum and colon were extremely full of faeces. Oral laxatives and enemas were prescribed, but the man refused to take any enemas.

Just two days later, the patient was back in the ER. A second CT scan revealed that faeces and air had leaked into the man’s abdomen through a rip in his colon. Doctors repaired the hole during emergency surgery and performed a colostomy, which allows bowel movements to pass through the abdomen into a bag.

The man was rushed to the operating room where surgeons performed a Hartman procedure to fix the life-threatening tear on his colon Image Courtesy: BMJ Case Reports
The man was rushed to the operating room where surgeons performed a Hartman procedure to fix the life-threatening tear on his colon Image Courtesy: BMJ Case Reports

To be clear, most constipated people don’t suffer such drastic consequences. Doctors believe this patient’s case was so extreme because he had chronic megacolon, or an enlarged, hyper-dilated colon. This makes it difficult for the muscles in the intestine to contract, which help faeces move more easily.

“This was a very challenging case. This patient had autism spectrum disorder. Chronic constipation is very common in these patients as well as (their) non-compliance with medical advice. It was difficult to get consent to offer elective surgery. The result was bowel perforation and an emergency operation. This was a rare and extreme case,”Alexandros Apostolopoulos, paper co-author and surgeon at Newham University Hospital in London, wrote to Gizmodo.

While this case is undeniably tragic, megacolons are fairly rare, so you likely don’t have to worry about the condition. You’re much more likely to just suffer from a routine case of constipation.

Thankfully, constipation can easily be combatted by eating the right foods, such as oatmeal, sweet potatoes, dates and prunes.

Source: Men’s Health