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Miscellanea
Images in paediatrics
Shock due to faecal impaction
  1. Ji Soo Baik1,
  2. Timothy Seers1,
  3. Sabeena Qureshi2,
  4. Simon Nadel2
  1. 1 Imperial College Faculty of Medicine, Imperial College London, London, UK
  2. 2 Paediatric Intensive Care Unit, St Mary’s Hospital, London, UK
  1. Correspondence to Dr Simon Nadel, Paediatric Intensive Care Unit, St Mary’s Hospital, Praed Street, London W2 1NY, UK; s.nadel{at}imperial.ac.uk

https://doi.org/10.1136/archdischild-2017-312672

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    A 15-year-old boy with quadriplegic cerebral palsy presented with a 2-day history of profuse diarrhoea and a 12-hour history of ‘coffee-ground’ vomiting. He had a prolonged history of poorly controlled constipation and diarrhoea, treated with regular movicol.

    The patient was hypotensive, with metabolic acidosis and hyperlactaemia, and was therefore intubated and ventilated and needed fluid resuscitation and inotropic support. Investigations revealed C reactive protein 350 mg/L and white cell count 30×1012/L. …

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    Footnotes

    • Contributors All authors contributed to this report. JSB

      and TS were medical students attached to the PICU when the child was admitted and carried out the research and wrote the manuscript. SQ

      and SN managed the patient, edited the manuscript and obtained the consent for publication.

    • Competing interests None declared.

    • Patient consent Obtained from guardian.

    • Provenance and peer review Not commissioned; externally peer reviewed.