Objective: To report the case of a Parkinson’s disease patient suffering from constipation complicated with a sigmoid volvulus and definitive colostomy

Background: Non-motor features of Parkinson’s disease are receiving greater recognition. Constipation symptoms can precede somatomotor symptoms in years, it is important to recognize and treat them as they can lead to other serious complications such as volvulus and ultimately colostomy.

Method: Case report.

Results: A 55-year-old man, university professor, with a history of constipation and distressing dreams, noticed that the kinetic watch he wore on his left wrist had stopped working. He later developed tremors in the same hand. The patient was observed in the outpatient clinic and the neurological examination was relevant for bradykinesia, rigidity and resting tremor in the left upper limb. He was diagnosed with Parkinson’s disease (PD) and started treatment with ropinirole and later with rasagiline with motor benefit. Two years later, he started levodopa, and in the fourth year after diagnosis, he presented with motor fluctuations. At this time, he experienced worsening constipation with recurrent visits to the emergency department due to episodes of intestinal obstruction. A sigmoid volvulus was diagnosed, initially resolved endoscopically but due to high recurrence finally required open surgery with resection and anastomosis. Due to surgical complications, the patient was admitted to the ICU and underwent several surgical interventions, requiring definitive colostomy.

Conclusion: This case illustrates a serious complication of a common problem in Parkinson’s disease, early recognition and treatment of constipation in PD patients may alter complications like sigmoid volvulus and colostomy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/constipation-in-parkinsons-disease-a-common-problem-with-rare-but-serious-complications/