Open AccessClozapine-induced stercoral colitis: a surgical perspective
Author(s) -
Jayan George,
Richard Hotham,
William Melton,
Keith Chapple
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-227718
Subject(s) - medicine , clozapine , constipation , ileostomy , abdomen , abdominal pain , pelvis , schizophrenia (object oriented programming) , colectomy , general surgery , surgery , disease , ulcerative colitis , psychiatry
We describe a case of a 46-year-old man with schizophrenia treated with clozapine who presented as an emergency with abdominal pain on the background of a 1 month history of constipation. The initial presenting symptoms were vague and a diagnosis was difficult to establish. Initial CT of the abdomen and pelvis demonstrated only minor abnormalities. He continued to deteriorate until a further CT scan revealed worsening stercoral colitis. He subsequently underwent an emergency total colectomy and ileostomy formation and had a complicated prolonged postoperative recovery. This case highlights the risks that clozapine can have on slowing bowel transit and the dangerous consequences that can occur if not identified early.