Colonic Necrosis with Kayexalate-Sorbitol Enemas after Renal Transplantation

Brief Reports1 December 1989Colonic Necrosis with Kayexalate-Sorbitol Enemas after Renal TransplantationF. Taylor Wootton, MD, David F. Rhodes, MD, William M. Lee, MD, C. Thomas Fitts, MDF. Taylor Wootton, MD, David F. Rhodes, MD, William M. Lee, MD, C. Thomas Fitts, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-11-947 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptGastrointestinal complications are common in uremia and after renal transplantation. Why intestinal necrosis, a catastrophic event in renal transplantation, occurs is unclear. In many instances, colonic injury does not appear to be a direct result of mesenteric vascular compromise. We report a case of unexplained colonic necrosis in a renal transplant recipient occurring less than 24 hours after he had received four enemas with sodium polystyrene sulfonate suspension (Kayexalate, Roxane Laboratories, Columbus, Ohio) in sorbitol for hyperkalemia. This severe complication may be a direct result of the use of such enemas.Case ReportA 48-year-old white man with end-stage renal...References1. PerloffChonPetrellaGrossmanBarker LHERC. Acute colitis in the renal allograft recipient. Ann Surg. 1976;183:77-83. CrossrefMedlineGoogle Scholar2. FlaniganReckardLucas RCB. Colonic complications of renal transplantation. J Urol. 1988;139:503-6. CrossrefMedlineGoogle Scholar3. KomorowskiCohenKaufmannAdams REHM. Gastrointestinal complications in renal transplant patients. Am J Clin Pathol. 1986;86:161-7. CrossrefMedlineGoogle Scholar4. StylianosFordeBenvenistyHardy SKAM. Lower gastrointestinal hemorrhage in renal transplant recipients. Arch Surg. 1988;123:739-44. CrossrefMedlineGoogle Scholar5. LillemoeRomoloHamiltonPenningtonBurdickWilliams KJSLJG. Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. Surgery. 1987;101:266-72. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: F. Taylor Wootton, MD; David F. Rhodes, MD; William M. Lee, MD; C. Thomas Fitts, MDFrom the Medical University of South Carolina, Charlestown, South Carolina. For current author addresses, see end of text. 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Shepard, MDSummary and CommentSodium Polystyrene-Sorbitol EnemasRichard J. Burnett, PharmDGastrointestinal Complications in Dialysis Patients 1 December 1989Volume 111, Issue 11Page: 947-949KeywordsNecrosisRenal failureRenal transplantationSodiumSurgery ePublished: 1 December 2008 Issue Published: 1 December 1989 PDF downloadLoading ...