Sodium Polystyrene Sulfonate-Induced Massive Bowel Necrosis With Distant Extraintestinal Crystal Deposition: A Case Report and Review of the Literature
- PMID: 39553032
- PMCID: PMC11563774
- DOI: 10.7759/cureus.71523
Sodium Polystyrene Sulfonate-Induced Massive Bowel Necrosis With Distant Extraintestinal Crystal Deposition: A Case Report and Review of the Literature
Abstract
Sodium polystyrene sulfonate (SPS), a cation-exchange resin, has been a mainstay in long-term hyperkalemia management but is associated with significant gastrointestinal complications, particularly when used with sorbitol. The deposition of SPS crystals within the intestinal mucosa has been suggested to precipitate ischemia, necrosis, and ulcerations, ultimately leading to bowel perforation. This case report details a striking instance of massive bowel perforation subsequent to SPS administration, with accompanying findings of disseminated crystals in distant organs and tissues upon autopsy. Additionally, we provide a comprehensive review of the existing literature on this rare yet significant drug-induced side effect.
Keywords: autopsy findings; bowel perforation; cation-exchange resin; drug-induced bowel injury; extraintestinal crystal deposition; sodium polystyrene sulfonate.
Copyright © 2024, Brezic et al.
Conflict of interest statement
Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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