Neurogenic Megacolon in Spinal Cord Injury
A 44-year-old man with a 20-year history of quadriplegia from a gunshot wound to the neck presented to the emergency department with symptoms of a urinary tract infection. His medical history included chronic megacolon and neurogenic bladder, and he had been admitted to the hospital many times for the management of urinary tract infections and constipation. On physical examination, his abdomen was distended, soft, nontender, and tympanic to percussion, with normal bowel sounds. Extremely large, intermittent waves of peristalsis were noted (see video), and the patient reported mild cramping and a bloating sensation in association with this finding....