Cecal gangrene – Unusual complication of manual bowel decompression

Abstract

We present a case of a 31-year-old female who presented with complaints of obstipation. Imaging features were suggestive of small bowel obstruction with transition point at distal ileum. On emergency laparotomy, the patient was found to have fecal impaction, for which manual bowel decompression (milking) was done. The patient developed hypotension intraoperatively requiring ICU admission for post-operative management. Post-operative CT demonstrated features of hypotension with gangrenous changes in the cecal wall. Re-exploration surgery demonstrated features of cecal gangrene consistent with imaging findings.