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Case Reports
. 2019 Aug 30;12(8):e227718.
doi: 10.1136/bcr-2018-227718.

Clozapine-induced stercoral colitis: a surgical perspective

Jayan George  1   2 , Richard Hotham  3 , William Melton  3 , Keith Chapple  3
Affiliations
Case Reports

Clozapine-induced stercoral colitis: a surgical perspective

Jayan George et al. BMJ Case Rep. .

Abstract

We describe a case of a 46-year-old man with schizophrenia treated with clozapine who presented as an emergency with abdominal pain on the background of a 1 month history of constipation. The initial presenting symptoms were vague and a diagnosis was difficult to establish. Initial CT of the abdomen and pelvis demonstrated only minor abnormalities. He continued to deteriorate until a further CT scan revealed worsening stercoral colitis. He subsequently underwent an emergency total colectomy and ileostomy formation and had a complicated prolonged postoperative recovery. This case highlights the risks that clozapine can have on slowing bowel transit and the dangerous consequences that can occur if not identified early.

Keywords: drugs: psychiatry; gastrointestinal surgery; schizophrenia.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Axial CT image showing thickening of the wall of the sigmoid colon (A).
Figure 2
Figure 2
Axial CT image at a similar level showing increased thickening of the wall of the sigmoid (A) and descending colon (B).
Figure 3
Figure 3
Axial CT image showing increased thickening of the sigmoid colon (A) and ascites (C).
See this image and copyright information in PMC

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