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Death by Disimpaction: A Bradycardic Arrest Secondary to Rectal Manipulation
Christopher S Sampson1, Cory M Shea1
1Department of Emergency Medicine, University of Missouri-Columbia, One Hospital Drive, DC 029.1, Columbia, MO 65212, USA.
Case Reports in Emergency Medicine
|January 25, 2017
Summary
Rectal examination can rarely cause cardiac arrest. This case highlights the importance of pain management and close monitoring during rectal procedures, especially for patients with severe constipation.
Area of Science:
- Emergency Medicine
- Gastroenterology
- Cardiology
Background:
- Rectal examination and fecal disimpaction are routine procedures in the Emergency Department.
- These interventions are frequently performed for conditions like constipation and abdominal distention.
Observation:
- A 66-year-old male presented with abdominal distention and constipation.
- During a rectal examination, the patient experienced apnea and pulseless electrical activity (PEA) with bradycardia.
Findings:
- The patient suffered a cardiac arrest during the rectal examination.
- The cardiac arrest was likely a consequence of rectal manipulation.
Implications:
- This case underscores the potential risks associated with rectal procedures.
- Recommendations include adequate analgesia and continuous patient monitoring during these interventions, particularly for individuals with significant fecal impaction.
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