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- W4306177497 abstract "Introduction: Kayexalate (sodium polystyrene sulfonate) is commonly used for the treatment of hyperkalemia. There are reports of gastrointestinal (GI) tract necrosis and perforations associated with Kayexalate, most commonly in the colon, followed by the small intestine, and less frequently the esophagus and stomach. However, there are no publications that we are aware of on the effect of Kayexalate on the healing of repaired duodenal ulcers or new upper GI anastomoses. Kayexalate-induced GI perforations have an alarming rate of mortality, up to 33%. Methods: This is a case report of a novel finding of Kayexalate crystals in the specimen of a gastric antrectomy after failed Graham patch of a perforated duodenal ulcer. Results: A 74-year-old woman sustained a hip fracture and underwent hemiarthroplasty. On hospital day 7 she developed hyperkalemia and received sorbitol-based Kayexalate orally, shortly thereafter she developed abdominal pain and was diagnosed with free intraabdominal air. She was taken for exploratory laparotomy where 2 duodenal ulcers were found and repaired with Graham patch. She developed a postoperative leak and subsequently underwent gastrectomy with Billroth-II reconstruction. Pathology examination showed the presence of Kayexalate crystals in duodenal wall and evidence of necrosis. Conclusion: Kayexalate in sorbitol base is known to cause bowel necrosis; its effect on the upper GI tract is less understood. This is the first documented case possibly showing a link between oral kayexalate administration and adverse effects on gastrointestinal healing. We conclude that kayexalate use in cases of recent GI anastomosis deserves further investigation to document its safe use." @default.
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- W4306177497 date "2022-10-17" @default.
- W4306177497 modified "2023-10-17" @default.
- W4306177497 title "Kayexalate And Upper Gastrointestinal Leak: Causation or Correlation?" @default.
- W4306177497 doi "https://doi.org/10.1097/01.xcs.0000895840.78942.73" @default.
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