A Case of Sigmoid Colon Perforative Peritonitis in a Hemodialysis Patient Taking Sodium Polystyrene Sulfonate（Kayexalate）

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  • ポリスチレンスルホン酸ナトリウム（ケイキサレート）服用中の透析患者に発症したS状結腸穿孔性腹膜炎の1例

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Abstract

<p>A 78-year-old woman who had been on maintenance hemodialysis for diabetic nephropathy since 2005 and had taken sodium polystyrene sulfonate （Kayexalate, SPS） to control her potassium levels presented to our hospital with a history of abdominal pain. Abdominal computed tomography revealed free air and feces outside the intestinal tract. We diagnosed perforation of the sigmoid with perforative peritonitis, and performed emergency Hartmann’s operation. A 2-cm perforation was detected in the sigmoid colon. On histopathological examination, the SPS was found adhering to the perforated site on the intestine. As perforation and ulceration of the intestine have been reported as side effects of SPS, we considered that the perforation of the sigmoid colon in the present case might have been caused by the SPS.</p>

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