Hypermagnesemia caused by fecal-mass obstruction in stenotic rectal cancer following preoperative administration of magnesium citrate.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2024-12-20 DOI:10.1186/s40981-024-00759-4

Yuri Sato, Eiji Hashiba, Yuuma Yamazaki, Koudai Kato, Hirotaka Kinoshita, Satoko Noguchi, Tomoyuki Kudo, Kazuyoshi Hirota

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Abstract

Background: Hypermagnesemia is a rare complication, leading to fatal cardiovascular and respiratory conditions. We present severe hypermagnesemia developed in a patient with a rectal stenosis after pretreatment with oral magnesium citrate for rectosigmoid surgery.

Case presentation: A 78-year-old woman demonstrated consciousness disturbance, muscle weakness, and respiratory depression requiring tracheal intubation after preparation with oral magnesium for rectosigmoid surgery. Endoscopic examination showed a rectal obstruction due to fecal impaction. General condition improved after emergency Hartmann's surgery. Blood test revealed a remarkable increase of serum magnesium level to 17.5 mg/dL when the general condition deteriorated, which would have been responsible for her symptoms. She was discharged from the ICU after extubation on the third postoperative day with a normal magnesium level.

Conclusions: Pretreatment with large doses of oral magnesium-containing bowel cleanser may cause severe hypermagnesemia in patients with colorectal stenosis.

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术前给予柠檬酸镁治疗的狭窄性直肠癌患者粪块阻塞引起高镁血症。

背景：高镁血症是一种罕见的并发症，可导致致命的心血管和呼吸系统疾病。我们报告一例直肠乙状结肠手术后口服柠檬酸镁预处理的直肠狭窄患者出现严重的高镁血症。病例介绍：一位78岁的女性在接受直肠乙状结肠手术口服镁制剂后，表现出意识障碍、肌肉无力和呼吸抑制，需要气管插管。内窥镜检查显示大便阻塞引起的直肠梗阻。紧急哈特曼手术后一般情况好转。血液检查显示，当一般情况恶化时，血清镁水平显着增加到17.5 mg/dL，这可能是导致她症状的原因。术后第三天拔管出院，镁水平正常。结论：大剂量口服含镁清肠剂预处理可能导致结直肠狭窄患者出现严重的高镁血症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.