An Uncommon Potentially Fatal Complication in a Patient without Predisposing Factor Following Oral Bowel Preparation Commonly Used for Colonoscopy

作     者：Iris Wai Sum Li Ling Pong Leung Sik Hon Tsui Iris Wai Sum Li;Ling Pong Leung;Sik Hon Tsui

作者机构：Queen Mary Hospital Hospital Authority Hong Kong China Emergency Medicine Unit Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China Department of Accident & Emergency Queen Mary Hospital Hospital Authority Hong Kong Special Administrative Region Hong Kong China 

出 版 物：《Open Journal of Emergency Medicine》 (急诊医学（英文）)

年 卷 期：2016年第4卷第1期

页      面：6-10页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Symptomatic Hypocalcaemia Hyperphosphatemia Sodium Phosphate Solution Bowel 

摘      要：We described the case report of a patient presented with no known predisposing factor, generalized malaise with vomiting, locked jaw, perioral paraesthesia, carpopedal spasm and a positive Chvostek’s sign which resulted from severe electrolyte disturbance at 5 hours after use of oral sodium phosphate solution (NaPO4) as bowel preparation for colonoscopy. On presentation, she developed hyperphosphatemia and symptomatic hypocalcaemia with serum phosphate of 1.84 mmol/L and adjusted calcium level 1.67 mmol/L respectively. Her symptoms subsided after immediate intravenous calcium gluconate followed by oral calcium supplement. The electrolyte disturbances were normalized with an uneventful clinical course. The potentially fatal complications of sodium phosphate solution which commonly prescribed as bowel preparation for conventional colonoscopy could develop though previously reported as uncommon in patients without predisposing factors, and should not be overlooked. Urgent assessment and immediate correction of electrolyte disturbances are needed. Recommendations on patient selection of use of sodium phosphate to minimize risk of developing adverse events are needed to incorporate in clinical protocols.