Ileum and colon perforation following peritoneal dialysis-related peritonitis and high-dose calcium polystyrene sulfonate
Journal
Journal of the Formosan Medical Association
Journal Volume
114
Journal Issue
10
Pages
1008-1010
Date Issued
2015
Author(s)
Abstract
A rare but severe complication, intestinal necrosis, has been reported after sodium polystyrene sulfonate (SPS; Kayexalate) and sorbitol intake. Some case reports described bowel perforation following calcium polystyrene sulfonate (CPS; Kalimate) administration. We report a case of ileum and colon perforation following peritoneal dialysis-related peritonitis and high-dose Kalimate in a 59-year-old female patient. The patient had a history of hypertension, diabetes mellitus, and end-stage renal disease (ESRD). During hospitalization for peritoneal dialysis-related peritonitis, she developed hyperkalemia, and Kalimate was administered orally. However, severe abdominal distension and pain occurred just one day after Kalimate intake. An urgent surgery disclosed several perforations in the ileum and sigmoid colon. Pathology of the resected gut showed transmural necrosis and perforation with basophilic angulated crystals. The patient finally expired during hospitalization due to refractory septic shock. ? 2013.
SDGs
Other Subjects
polystyrenesulfonate calcium; polystyrene derivative; polystyrenesulfonic acid; sorbitol; abdominal distension; abdominal pain; adult; Article; basophil; case report; colon perforation; continuous ambulatory peritoneal dialysis; crystal; disease severity; drug megadose; female; histopathology; hospitalization; human; human tissue; hyperkalemia; intestine necrosis; middle aged; peritonitis; septic shock; sigmoid; small intestine perforation; adverse effects; colon; fatality; hyperkalemia; ileum; Intestinal Perforation; Kidney Failure, Chronic; necrosis; pathology; peritoneal dialysis; peritonitis; Shock, Septic; Colon; Fatal Outcome; Female; Humans; Hyperkalemia; Ileum; Intestinal Perforation; Kidney Failure, Chronic; Middle Aged; Necrosis; Peritoneal Dialysis; Peritonitis; Polystyrenes; Shock, Septic; Sorbitol
Publisher
Elsevier
Type
journal article