Emergency Laparotomy for Abdominal Compartment Syndrome in a Child due to Chronic Functional Constipation

Area of Science:

• Pediatric Surgery
• Pediatric Gastroenterology
• Pediatric Critical Care

Background:

• Functional constipation (FC) is common in children, with stressful life events identified as a risk factor.
• Abdominal compartment syndrome (ACS) is a critical condition with significant morbidity and mortality in pediatric patients.

Observation:

• A 13-year-old male with chronic FC, stemming from parental separation, presented with severe abdominal distension, hypertension, and refractory seizures.
• Imaging revealed extensive rectosigmoid bowel dilatation, prompting suspicion of ACS.
• Intravesical measurement confirmed elevated intra-abdominal pressure (IAP), indicative of ACS.

Findings:

• The patient underwent urgent decompression laparotomy (DL) with bowel resection.
• Postoperative improvement was observed, highlighting the effectiveness of surgical intervention.

Implications:

• This case underscores the rare but critical association between severe functional constipation and abdominal compartment syndrome in pediatric patients.
• Early recognition and surgical management are vital for improving outcomes in such complex cases.
• The impact of psychosocial stressors on pediatric gastrointestinal and critical care conditions warrants further investigation.