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Cauda equina syndrome secondary to constipation: an uncommon occurrence
Nathan Lawrentschuk1, Hung Nguyen
1Department of Surgery, Launceston General Hospital, Launceston, Tasmania, Australia. mayjay@ozemail.com.au
ANZ Journal of Surgery
|June 10, 2005
Summary
Severe constipation can mimic serious spinal cord conditions. This case highlights how fecal impaction can cause cauda equina syndrome, with rapid recovery after treatment.
Area of Science:
- Neurology
- Gastroenterology
- Emergency Medicine
Background:
- Spinal cord and cauda equina pathologies are medical emergencies requiring prompt evaluation.
- Severe constipation is a diagnosis of exclusion but can lead to significant morbidity.
- Constipation can present with symptoms mimicking acute abdomen, sepsis, or spinal pathology.
Observation:
- A case study of a young man presenting with symptoms suggestive of cauda equina syndrome.
- Initial investigations excluded neurological and bony abnormalities as the cause.
- The patient's symptoms were ultimately attributed to severe constipation with fecal impaction.
Findings:
- Constipation with fecal impaction was identified as the cause of cauda equina syndrome in this patient.
- Exclusion of nerve and bony pathology was crucial in diagnosing the underlying cause.
- Treatment of the constipation led to rapid improvement in neurological signs and urinary retention.
Implications:
- This case underscores the importance of considering severe constipation in the differential diagnosis of cauda equina syndrome.
- Prompt recognition and management of fecal impaction can prevent long-term neurological sequelae.
- Highlights the potential for gastrointestinal issues to present as neurological emergencies.