Sato Yuri, Hashiba Eiji, Yamazaki Yuuma, Kato Koudai, Kinoshita Hirotaka, Noguchi Satoko, Kudo Tomoyuki, Hirota Kazuyoshi
Department of Anesthesiology, Aomori Prefectural Central Hospital, 2-1-1 Higashitsukurimichi, Aomori, 030-8553, Japan.
Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
JA Clin Rep. 2024 Dec 20;10(1):77. doi: 10.1186/s40981-024-00759-4.
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.
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.
Pretreatment with large doses of oral magnesium-containing bowel cleanser may cause severe hypermagnesemia in patients with colorectal stenosis.
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。我们报告了一例在直肠乙状结肠手术前口服枸橼酸镁进行预处理后，一名患有直肠狭窄的患者发生严重高镁血症的病例。
一名78岁女性在直肠乙状结肠手术口服镁剂准备后，出现意识障碍、肌肉无力和呼吸抑制，需要气管插管。内镜检查显示因粪便嵌塞导致直肠梗阻。急诊哈特曼手术后，患者的一般状况有所改善。当患者一般状况恶化时，血液检查显示血清镁水平显著升高至17.5mg/dL，这可能是导致其症状的原因。术后第三天拔管后，患者血清镁水平恢复正常，从重症监护病房出院。
大剂量口服含镁肠道清洁剂进行预处理可能会导致结直肠狭窄患者发生严重高镁血症。
