Document Detail

Successful treatment of a colonic ulcer penetrating the urinary bladder caused by the administration of calcium polystyrene sulfonate and sorbitol.
MedLine Citation:
PMID:  17965530     Owner:  NLM     Status:  MEDLINE    
A 77-year-old woman was urgently admitted for the treatment of diabetic ketoacidosis and a duodenal ulcer hemorrhage in March 1999. She had a history of diabetes and angina pectoris. After admission, she received oral calcium polystyrene sulfonate and sorbitol to treat hyperkalemia. Nine days later, severe abdominal pain developed. A colonoscopic examination revealed a sigmoid colonic ulcer and stenosis; the patient was treated conservatively. At a 1-year follow-up examination, the colonic stenosis was found have worsened; pneumaturia developed in January 2001. The patient was found to have a sigmoidovesical fistula and underwent sigmoidectomy and partial resection of the ileum and urinary bladder. The histological findings were a benign colonic ulcer with the infiltration of inflammatory cells, mainly lymphocytes. Rhomboidal, dark violet Kayexalate crystals were observed on microscope examination in the submucosa in both the first and second colonic biopsy specimens. We concluded that the colonic ulcer and the sigmoidovesical fistula had been caused by the administration of calcium polystyrene sulfonate and sorbitol. Reports of colonic perforation as a result of the administration of calcium polystyrene sulfonate and sorbitol are rare. Here, we report the successful treatment of a colonic ulcer that had penetrated the urinary bladder.
Takeshi Shioya; Masanori Yoshino; Masao Ogata; Tetsuo Shibuya; Akira Tokunaga; Koshi Matsumoto; Takashi Tajiri
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of Nippon Medical School = Nippon Ika Daigaku zasshi     Volume:  74     ISSN:  1345-4676     ISO Abbreviation:  J Nippon Med Sch     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-29     Completed Date:  2007-12-28     Revised Date:  2012-09-25    
Medline Journal Info:
Nlm Unique ID:  100935589     Medline TA:  J Nippon Med Sch     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  359-63     Citation Subset:  IM    
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Japan.
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MeSH Terms
Colonic Diseases / chemically induced*,  surgery
Digestive System Surgical Procedures
Hypokalemia / drug therapy
Intestinal Fistula / chemically induced*,  surgery
Polystyrenes / adverse effects*
Sigmoid Diseases / chemically induced*,  surgery
Sorbitol / adverse effects*
Treatment Outcome
Ulcer / chemically induced*,  surgery
Reg. No./Substance:
0/Polystyrenes; 28210-41-5/polystyrene sulfonic acid; 50-70-4/Sorbitol

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