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Case Reports in Emergency Medicine
Volume 2016, Article ID 5489325, 3 pages
Case Report

Death by Disimpaction: A Bradycardic Arrest Secondary to Rectal Manipulation

Department of Emergency Medicine, University of Missouri-Columbia, One Hospital Drive, DC 029.1, Columbia, MO 65212, USA

Received 15 November 2016; Accepted 14 December 2016

Academic Editor: Aristomenis K. Exadaktylos

Copyright © 2016 Christopher S. Sampson and Cory M. Shea. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Rectal examination and fecal disimpaction are common procedures performed in the Emergency Department on a daily basis. Here, we report a rare case of a patient suffering a cardiac arrest and ultimately death likely due to rectal manipulation. A 66-year-old male presented to the Emergency Department (ED) with a complaint of abdominal distention and constipation. A rectal exam was performed. During the examination the patient became apneic. On the cardiac monitor the patient was found to be in pulseless electrical activity with a bradycardic rate. Our recommendation would be to provide adequate analgesia and close patient monitoring of those undergoing this procedure especially patients with significant stool burdens.