P3684 - Lower Extremity Venous Hypertension – A Rare Complication of Fecaloma

Irfa Tariq, MD¹, Benjamin Pflederer, MD², Daniel B. Gans, MD^2
1Brookdale University Hospital Medical Center, Brooklyn, NY; ²OSF Saint Francis Medical Center, Peoria, IL

Introduction: Iliac vein compression syndrome presents with a wide range of clinical symptoms. Although it is widely associated with May Thurner syndrome, it can also present due to compression by other surrounding structures. Fecaloma is a potential rare cause of iliac vein compression and vascular insufficiency, as highlighted in our case. Patients with chronic constipation, especially the ones on opioid therapy, should be carefully monitored and adequately treated to prevent complications of fecaloma.

Case Description/Methods: An 85-year-old Caucasian male with a complex medical history including chronic opioid therapy presented with right leg pain. Initially, physical examination, diagnostics and evaluation excluded acute arterial insufficiency. Later, re-evaluation of imaging suggested a fecaloma leading to right iliac vein compression. Aggressive enema led to improvements in bowel function and lower extremity symptoms in our patient.

Discussion: Fecaloma should be excluded as a potential differential diagnosis of lower extremity symptoms in elderly patients with a history of chronic constipation. Early diagnosis and initiation of an aggressive bowel regimen remains important to prevent life and limb threatening complications.



Disclosures:


Irfa Tariq, MD¹, Benjamin Pflederer, MD², Daniel B. Gans, MD². P3684 - Lower Extremity Venous Hypertension – A Rare Complication of Fecaloma, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.