Skip to main content

Advertisement

SpringerLink
Log in

Hepatic portal venous gas due to polystyrene sulfonate-induced enteritis

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

A 78-year-old man with acute right lower abdominal pain and nausea was referred to our hospital. Computed tomography (CT) demonstrated hepatic portal venous gas and a thickened wall of the terminal ileum, and colonoscopy demonstrated ulcers and erosions of the ileocecal region. Histological examination of biopsy samples revealed basophilic crystals consistent with the component of calcium polystyrene sulfonate (CPS). This patient started taking CPS 2 months prior for chronic hyperkalemia. The symptoms resolved soon after ceasing CPS, and subsequent imaging studies confirmed the disappearance of the portal venous gas and ileocolitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Harel Z, Harel S, Shah PS, et al. Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Am J Med. 2013;126:e9–24.

    Article  CAS  Google Scholar 

  2. Arvanitakis C, Malek G, Uehling D. Colonic complications after renal transplantation. Gastroenterology. 1973;64:533–8.

    PubMed  CAS  Google Scholar 

  3. Shioya T, Yoshino M, Ogata M, et al. Successful treatment of a colonic perforation penetrating the urinary bladder caused by the administration of calcium polystyrene sulfonate and sorbitol. J Nippon Med Sch. 2007;74:359–63.

    Article  PubMed  Google Scholar 

  4. Goutorbe P, Montcriol A, Lacroix G, et al. Intestinal necrosis associated with orally administered calcium polystyrene sulfonate without sorbitol. Ann Pharmacother. 2011;45:e13.

    Article  PubMed  Google Scholar 

  5. Akagun T, Yazici H, Gulluoglu MG, et al. Colonic necrosis and perforation due to calcium polystyrene sulfonate in a uremic patient: a case report. NDT Plus. 2011;4:402–3.

    PubMed  PubMed Central  Google Scholar 

  6. Kao CC, Tsai YC, Chiang WC, et al. Ileum and colon perforation following peritoneal dialysis-related peritonitis and high-dose calcium polystyrene sulfonate. J Formos Med Assoc. 2015;114:1008–10.

    Article  PubMed  CAS  Google Scholar 

  7. Castillo-Cejas MD, de-Torres-Ramírez I, Alonso-Cotoner C. Colonic necrosis due to calcium polystyrene sulfonate (Kalimate) not suspended in sorbitol. Rev Esp Enferm Dig. 2013;105:232–4.

    Article  PubMed  Google Scholar 

  8. Lai TP, Yang CW, Siaop FY, et al. Calcium polystyrene sulfonate bezoar in the ileum: diagnosis and treatment with double-balloon endoscopy. Endoscopy. 2013;45(Suppl 2 UCTN):E378–9.

    PubMed  Google Scholar 

  9. Takeuchi N, Nomura Y, Meda T, et al. Development of colonic perforation during calcium polystyrene sulfonate administration: a case report. Case Rep Med. 2013;2013:102614.

    PubMed  PubMed Central  Google Scholar 

  10. Keng LT, Tsou PH. Unusual ileus due to calcium polystyrene sulfonate. Postgrad Med J. 2016;92:563.

    Article  PubMed  Google Scholar 

  11. Lillemoe KD, Romolo JL, Hamilton SR, et al. Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. Surgery. 1987;101:267–72.

    PubMed  CAS  Google Scholar 

  12. Ayoub I, Oh MS, Gupta R, et al. Colon necrosis due to sodium polystyrene sulfonate with and without sorbitol: an experimental study in rats. PLoS ONE. 2015;10:e0137636.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Abboud B, El Hachem J, Yazbeck T, et al. Hepatic portal venous gas: physiopathology, etiology, prognosis and treatment. World J Gastroenterol. 2009;15:3585–90.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-Ku, Sapporo, 060-8543, Japan

    Toshiyuki Kubo, Kentaro Yamashita, Yoshihiro Yokoyama, Daisuke Hirayama, Tomohiro Shirata, Kei Mitsuhashi, Kei Onodera, Eiichiro Yamamoto, Katsuhiko Nosho, Hiroo Yamano & Hiroshi Nakase

  2. Department of Gastroenterology and Hepatology, Hakodate Goryokaku Hospital, Hakodate, Japan

    Yoshihiro Yokoyama

  3. Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan

    Terufumi Kubo, Shintaro Sugita & Tadashi Hasegawa

Authors
  1. Toshiyuki Kubo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kentaro Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshihiro Yokoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daisuke Hirayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tomohiro Shirata
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kei Mitsuhashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kei Onodera
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Eiichiro Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Katsuhiko Nosho
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroo Yamano
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Terufumi Kubo
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Shintaro Sugita
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Tadashi Hasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Hiroshi Nakase
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toshiyuki Kubo.

Ethics declarations

Conflicts of interest

Toshiyuki Kubo, Kentaro Yamashita, Yoshihiro Yokoyama, Daisuke Hirayama, Tomohiro Shirata, Kei Mitsuhashi, Kei Onodera, Eiichiro Yamamoto, Katsuhiko Nosho, Hiroo Yamano, Terufumi Kubo, Shintaro Sugita, Tadashi Hasegawa and Hiroshi Nakase that they have no conflict of interest

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kubo, T., Yamashita, K., Yokoyama, Y. et al. Hepatic portal venous gas due to polystyrene sulfonate-induced enteritis. Clin J Gastroenterol 11, 220–223 (2018). https://doi.org/10.1007/s12328-018-0818-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-018-0818-8

Keywords

Search

Navigation