![]() Treatment was therefore provided in the form of 5% glucose solution, calcium gluconate and KCl via the intravenous route. In view of these clinical and laboratory test data, dialysis was indicated but rejected by the family. Emergency laboratory testing revealed the following: urea 104 mg/dl, creatinine 2.7 mg/dl, Na 161 mEq/l, K 2.4 mEq/l, Ca 5.3 mg/dl, P 22 mg/dl and venous blood gases indicating pH 7.6, bicarbonate 12.8 mEq/l and pCO2 13 mmHg. A few hours later the patient suffered obnubilation and generalized During the first few days of admission the patient failed to improve a rectal tube was thus placed for the instilment of four 250-ml Casen® enemas. Mentioned diagnosis, as a result of which decompression was carried out with the aspiration of 2000 ml of fecaloidįluid. MEq/l, K 5.7 mEq/l, and a urinary sediment with leukocyturia and bacteruria. The laboratory tests revealed the following: glucose 153 mg/dl, urea 186 mg/dl, creatinine 3.5 mg/dl, Na 140 ![]() The abdominal Xrays revealed important colon dilatation without evidence of obstruction, while the CAT scan showed important dilatation from cecum to rectum, suggestive of acute colon pseudo-obstruction or Ogilvy¿s syndrome (fig. There were no other findings of interest. The physical examination revealed the following: good hydration with blood pressure 150/70 mmHg, severe abdominal bloating with pain in response to palpation, no defensive reaction or peritonism and metallic sounds. Sertraline, omeprazole, tramadol, paracetamol, risedronate and ferrous sulfate. Treatment consisted of metformin, insulin, indapamide, amlodipine, There were no data indicative of renal failure. She had a history of arterial hypertension, diabetes mellitus, anemia, osteoporosis and cognitive deterioration. In patients with renal failure, such enemas can produce severe hyperphosphoremia,1,2 as in the case described below.Ī 79-year old woman reported with abdominal pain and bloating, associated to constipation for the previous week. To the editor: The use of phosphorus (P)-containing enemas is common practice as preparation for colonoscopy and for other applications (constipation, preoperative or pre-radiological intestinal cleansing), with generally unknown side effects.
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