Abstract and Introduction
Colonic necrosis is an unusual complication after treatment of hyperkalemia with sodium polystyrene sulfonate (SPS, Kayexalate) in sorbitol. To increase awareness of this complication, we report a case of necrosis of the transverse colon in a patient given oral and rectal SPS-sorbitol for hyperkalemia. Colonic necrosis was manifested as an acute abdomen within 24 hours of initial administration. Prompt surgical resection of the necrotic transverse colon permitted rapid recovery of bowel function. Although SPS crystals are seen microscopically in the necrotic bowel, experimental evidence implicates the sorbitol component of the SPS-sorbitol in the pathogenesis of colonic necrosis. A high index of suspicion for the unusual complication of colonic necrosis after oral or rectal administration of SPS-sorbitol may allow prompt recognition and surgical cure.
Hyperkalemia may be treated by various methods, including the oral or rectal administration of the sodium-potassium ion-exchange resin sodium polystyrene sulfonate (SPS, Kayexalate). Introduced in 1961 and approved for use in the United States in 1975, SPS was originally administered in a simple suspension. However, sorbitol solution is commonly used to dissolve the SPS and reduce fecal impaction and subsequent bowel obstruction.
Complications associated with SPS-sorbitol include nausea, vomiting, anorexia, diarrhea, and electrolyte abnormalities. Colonic necrosis has on occasion been reported. The purpose of this communication is to report a case of SPS-sorbitol-induced colonic necrosis and review the relevant literature.
South Med J. 2000;93(5) © 2000 Lippincott Williams & Wilkins
Cite this: Acute Abdomen With Colonic Necrosis Induced by Kayexalate-Sorbitol - Medscape - May 01, 2000.
