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Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
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Fecal Impaction Causing Pelvic Venous Compression and Edema.

Sara Naramore1, Faisal Aziz2, Chandran Paul Alexander3

  • 1Department of Pediatrics, Penn State Milton S Hershey Medical Center , PA, USA.

Pediatric Reports
|October 27, 2015
PubMed
Summary

Severe fecal impaction in a child caused pelvic venous compression, leading to leg and perineal edema. Treatment with disimpaction and laxatives resolved the edema and constipation.

Keywords:
Pedal edemaconstipationduplex ultrasoundfecal impactionpolyethylene glycol 3350 with electrolytes

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Area of Science:

  • Pediatric Gastroenterology
  • Vascular Medicine

Background:

  • Chronic constipation is a prevalent condition in children, potentially leading to severe fecal impaction.
  • Fecal impaction can present with complex symptoms beyond gastrointestinal distress.

Observation:

  • A 13-year-old male with chronic constipation and encopresis developed a three-week fecal impaction.
  • The impaction caused severe abdominal pain, distension, encopresis, decreased oral intake, and bilateral pedal and perineal edema.
  • Edema worsened with fluid administration, raising concerns for venous compression or thrombosis.

Findings:

  • Duplex Ultrasound revealed altered venous waveforms in the external iliac and common femoral veins, but no thrombosis.
  • Manual disimpaction and treatment with polyethylene glycol 3350 and electrolytes successfully resolved the edema.
  • Follow-up showed resolution of constipation and edema, with normal venous Doppler studies.

Implications:

  • Severe fecal impaction can precipitate pelvic venous compression syndrome in pediatric patients.
  • This case highlights the importance of considering extragastrointestinal complications of severe constipation.
  • Prompt recognition and management of fecal impaction are crucial to prevent serious sequelae like venous compromise.