clozapine and Abdominal-Pain

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.

Topics: Abdominal Pain; Antipsychotic Agents; Clozapine; Colitis; Humans; Male; Middle Aged; Schizophrenia

Topics: Abdominal Pain; Adult; Antipsychotic Agents; Clozapine; Combined Modality Therapy; Diagnostic Errors; Dibenzothiazepines; Drug Therapy, Combination; Female; Fever; Fluid Therapy; Headache; Hemodiafiltration; Humans; Lithium; Multiple Organ Failure; Norepinephrine; Quetiapine Fumarate; Schizophrenia; Systemic Inflammatory Response Syndrome; Urinary Tract Infections; Valproic Acid; Vasoconstrictor Agents

Topics: Abdomen; Abdominal Pain; Acute Disease; Adult; Blood Coagulation Disorders; Clozapine; Colon; Diagnosis, Differential; Dilatation, Pathologic; Gastrointestinal Motility; Humans; Male; Megacolon, Toxic; Radiography; Schizophrenia, Paranoid; Serotonin Antagonists; Shock, Septic