An Uncommon Potentially Fatal Complication in a Patient without Predisposing Factor Following Oral Bowel Preparation Commonly Used for ColonoscopyReport as inadecuate




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We described the case report of a patient presented with no known predisposing factor, generalizedmalaise with vomiting, locked jaw, perioral paraesthesia, carpopedal spasm and a positiveChvostek’s sign which resulted from severe electrolyte disturbance at 5 hours after use of oral sodiumphosphate solution NaPO4 as bowel preparation for colonoscopy. On presentation, shedeveloped hyperphosphatemia and symptomatic hypocalcaemia with serum phosphate of 1.84mmol-L and adjusted calcium level 1.67 mmol-L respectively. Her symptoms subsided after immediateintravenous calcium gluconate followed by oral calcium supplement. The electrolyte disturbanceswere normalized with an uneventful clinical course. The potentially fatal complicationsof sodium phosphate solution which commonly prescribed as bowel preparation for conventionalcolonoscopy could develop though previously reported as uncommon in patients without predisposingfactors, and should not be overlooked. Urgent assessment and immediate correction ofelectrolyte disturbances are needed. Recommendations on patient selection of use of sodiumphosphate to minimize risk of developing adverse events are needed to incorporate in clinicalprotocols.

KEYWORDS

Symptomatic Hypocalcaemia, Hyperphosphatemia, Sodium Phosphate Solution, Bowel

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Li, I. , Leung, L. and Tsui, S. 2016 An Uncommon Potentially Fatal Complication in a Patient without Predisposing Factor Following Oral Bowel Preparation Commonly Used for Colonoscopy. Open Journal of Emergency Medicine, 4, 6-10. doi: 10.4236-ojem.2016.41002.





Author: Iris Wai Sum Li1*, Ling Pong Leung2, Sik Hon Tsui3

Source: http://www.scirp.org/



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