Hepatic venous outflow block caused by compressive fecaloma in a schizophrenic patient treated with clozapine

Drug Discoveries & Therapeutics
Michael OsseisDaniel Azoulay

Abstract

In Clozapine users constipation is among the reported side effects including agranulocytosis and myocarditis with prevalence rates ranging from 14% to 60%. In extreme cases this may lead to bowel obstruction and paralytic ileus which, if not detected and treated early, may lead to mortality up to 30%. We report the first case of hepatic outflow block secondary to compression of the liver by a distended colon upstream an impacted fecaloma in a 47-year old schizophrenic man treated by clozapine. Emergency sub-total colectomy was performed for pan-colonic ischemia. Surgery relieved the liver outflow block and was followed by uneventful outcome. Patients receiving clozapine should undergo routine laxatives and monitoring in order to limit the risk of clozapine-related ileus and bowel ischemia.

References

Oct 24, 2015·Postgraduate Medical Journal·Rishi M GoelTerence Wong

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Citations

Dec 13, 2017·CNS Drugs·Dan Cohen
Nov 24, 2018·Alimentary Pharmacology & Therapeutics·Ziga VodusekLawrence J Brandt

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