A Case Report of Undiagnosed Chronic Constipation With Considerable Stool Burden.

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Chronic constipation affects a significant portion of the population, sometimes leading to severe impaction (obstipation).
• This case involves a 25-year-old female with a history of chronic constipation and prior hospitalizations.

Observation:

• The patient presented with minimal stool passage for four months, a significantly impacted colon evident on CT scan, and a "clay-like" abdomen.
• Despite the severity, her vital signs and laboratory results were within normal limits.

Findings:

• Manual disimpaction successfully evacuated a substantial stool burden up to the distal sigmoid colon.
• The patient demonstrated significant improvement with a liquid diet, a bowel regimen, and medication (Miralax).

Implications:

• This case suggests that non-surgical management, including manual disimpaction and medical therapy, can be effective for severe constipation.
• While colectomy is often considered the definitive solution for severe cases, this instance indicates that surgical intervention might be deferred if medical management yields positive results.