Case presentation A 76-year-old woman presented to the emergency department with a four-day history of inability to pass stool or flatus. She also reported nausea and vomiting over the preceding day.
These symptoms were accompanied by continuous, dull, diffuse abdominal pain that was not relieved with medications. Medical history Long-standing constipation for 15 years Typically relieved with laxatives every 2–3 days Current episode not responding to medical therapy Physical examination Moderately built, coarse facies, dehydrated Dry skin, reduced skin turgor Abdominal examination Abdominal distension, no gross organomegaly Bowel sounds present in all quadrants, more prominent in the right lower quadrant Rectal examination Fecal staining present No gross abnormalities Laboratory findings Hemogram: Mild anemia, normal leucocyte count Liver and kidney function tests: Within normal limits…
