Clozapine Triggering Cecal Volvulus in a Patient With Malrotation and Schizophrenia: Side Effect That Needs Emphasis

Abstract

Clozapine induced gastrointestinal hypomotility (CIGH) has been suggested as one of the most common causes of significant morbidity and mortality. It commonly presents as constipation, but the reports of other small or large intestinal complications with fatal outcomes are not uncommon. Hereby, we report the case of a 24-year-old male, suffering from schizophrenia and being managed with clozapine, who developed symptoms of acute intestinal obstruction due to ceco-colic volvulus. Subsequently, he was found to have intestinal malrotation at emergency laparotomy and underwent de-rotation of cecal volvulus and right hemicolectomy. He did well in the postoperative period and afterwards.  Cecal volvulus which in itself is a rare cause of intestinal obstruction in adults has not been observed consequent to clozapine treatment and required surgical therapy.