Faecal impaction causing bilateral pelvic venous thrombosis.

INTRODUCTION: We present a first description of faecal impaction (FI) causing occlusion of the pelvic venous system, resulting in a bilateral thrombosis of the external iliac vein.

PATIENTS AND METHODS: Our 76-year-old female patient was admitted with gradual swelling of both legs. Clinical evaluation revealed a painless abdominal distension and marked bilateral edema of the legs. A computed tomography (CT) scan showed gross dilatation of the colon and rectum, with FI. A short bilateral occlusion of the external iliac vein was seen, with thrombus in both pelvic veins. Doppler ultrasonography confirmed a thrombosis of the external iliac vein and common femoral vein on both sides.

RESULTS: A conservative treatment consisting of manual evacuation, enema, laxatives and systemic anticoagulation was successfully applied.

CONCLUSIONS: FI represents a common - yet preventable - health problem, mainly in the elderly. This case illustrates a rare complication of FI if left untreated.