Emergency Laparotomy for Abdominal Compartment Syndrome in a Child due to Chronic Functional Constipation

Abdominal compartment syndrome (ACS) in children is a life-threatening complication with high morbidity and mortality. Stressful life events are among the risk factors of functional constipation (FC) in children. We present a 13-year-old male patient with chronic FC due to parents' separation who presented with a history of FC since infancy and inability to defecate during the last month. On examination, the abdomen was distended and tender. His vital signs revealed elevated blood pressure ≥ 95^th percentile according to his age weight and gender. On admission, the patient experienced tonic-clonic seizures refractory to medical therapy. He was intubated and a computed tomography (CT) scan revealed an extensive rectosigmoid bowel dilatation. Despite maximal medical support, his condition worsened. ACS was suspected and confirmed via intravesical measurement of intra-abdominal pressure (IAP). An urgent decompression laparotomy (DL) was performed with resection of the affected bowel. His condition improved postoperatively. This case highlights the extremely rare association between ACS and chronic FC resulting from stressful life events.