Acute colonic necrosis associated with sodium polystyrene sulfonate (Kayexalate) enemas in a critically ill patient: Case report and review of the literature
Acute colonic necrosis associated with sodium polystyrene sulfonate (Kayexalate) enemas in a critically ill patient: Case report and review of the literature
复制标题
DOI：
10.1097/00005373-200108000-00031
复制
发表时间：
2001-08-01
影响因子：
--
通讯作者：
Li, SC
中科院分区：
文献类型：
--
作者：
Rogers, FB;Li, SC
肾功能不全患者特别容易出现电解质异常，特别是高钾血症，这可能危及生命。治疗高钾血症的方法之一是使用聚苯乙烯磺酸钠（Kayexalate），这是一种阳离子交换树脂，可以通过灌肠、口服或鼻胃管给药。山梨醇是一种高渗混合物，经常与聚苯乙烯磺酸钠混合，以防止树脂引起的便秘。本文报告的病例是结肠坏死的灾难性并发症，我们认为是由治疗患者急性高钾血症的聚苯乙烯磺酸钠和山梨醇灌肠引起的。坏死结肠中的特征性结晶物质以及结肠坏死向下延伸至肛门边缘（结肠血管丰富的区域通常不易发生缺血）的事实证明了这一点。
Patients with renal insufficiency are particularly prone to electrolyte abnormalities, especially hyperkalemia, which can be life threatening. One of the methods to treat hyperkalemia is with sodium polystyrene sulfonate (Kayexalate), a cation-exchange resin that can be administered either as an enema, orally, or by nasogastric tube. Sorbitol is a hypertonic mixture that is frequently mixed with sodium polystyrene sulfonate to prevent constipation from the resin. The case reported herein is a catastrophic complication of colonic necrosis that we believe was caused by sodium polystyrene sulfonate and sorbitol enemas that were administered to treat the patient's acute hyperkalemia. This was evidenced by the characteristic crystallized material in the necrotic colon and the fact that the colonic necrosis extended down to the anal verge (a richly vascularized area of the colon usually not prone to ischemia).