Yonsei Med J.  2013 May;54(3):797-800. 10.3349/ymj.2013.54.3.797.

Hypermagnesemia Accompanied with Colonic Perforation in a Hemodialysis Patient

• Yoon HE
• Kim YW
• Ha KS
• Sim EH
• Go SW
• Shin SJ

• KMID: 1727901
• DOI: http://doi.org/10.3349/ymj.2013.54.3.797

Abstract

We report a case of a chronic hemodialysis patient who developed hypermagnesemia due to an overdose of magnesium-containing laxative and paralytic ileus resulting in colonic perforation. Despite intravenous calcium infusion and daily hemodialysis, the patient developed ischemic colitis and intestinal perforation. Colonic perforation accompanied with hypermagnesemia in hemodialysis patients has rarely been reported. This case suggests that hypermagnesemia should be considered in renal failure patients as this can result in life-threatening events despite prompt treatment.

Keyword

Hypermagnesemia; paralytic ileus; colonic perforation; hemodialysis

MeSH Terms

Colitis, Ischemic/*chemically induced/diagnosis/surgery
Constipation/*drug therapy/surgery
Female
Humans
Intestinal Perforation/*chemically induced/surgery
Laxatives/adverse effects/*poisoning
Magnesium/*poisoning
Middle Aged
*Renal Dialysis
Laxatives
Magnesium

Figure

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  Fig. 1 Abdominal plain radiograph shows diffuse and marked dilatation of large bowel loops with fecal impaction.

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  Fig. 2 Clinical course of the patient. DTR, deep tendon reflex.

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  Fig. 3 Abdominal CT scan reveals large air fluid levels (arrows) in abdominal cavity.

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