We report a case of a chronic hemodialysis patient who developed hypermagnesemia due to an overdose of magnesium-containing laxative and paralytic ileus resulting in colonic perforation. Despite intravenous calcium infusion and daily hemodialysis, the patient developed ischemic colitis and intestinal perforation. Colonic perforation accompanied with hypermagnesemia in hemodialysis patients has rarely been reported. This case suggests that hypermagnesemia should be considered in renal failure patients as this can result in life-threatening events despite prompt treatment.
Colitis, Ischemic/*chemically induced/diagnosis/surgery ; Constipation/*drug therapy/surgery ; Female ; Humans ; Intestinal Perforation/*chemically induced/surgery ; Laxatives/adverse effects/*poisoning ; Magnesium/*poisoning ; Middle Aged ; *Renal Dialysis

Magnesium salts have been reported to be effective in the treatment of atrial, junctional and ventricular arrhythmias resulting from myocardial ischemia, digitalis poisoning, alcoholism, diuretic therapy and coronary artery disease. The mechanism of antiarrhythmic effect is thought to inhibit the efflux of potassium, supress inward sodium movement, and mimic calcium channel blocking drugs by inhibiting cellular calcium uptake. The purpose of this study is to evaluate the antiarrhythmic effect of MgSO4 by inhibiting intracellular calcium transport and dose-related effect. The experiments were composed of four steps. 16 ug/Kg of epinephrine was injected in twenty rabbits anesthetized with halothane (experiment 1). Ventricular arrhythmia was developed in all rabbits. At 15 minutes later, after the retum of sinus rhythm, CaCl2 (10 mg/Kg) was injected slowly for 5 min, and than 16 ug/Kg of epinephrine was injected immediately after the administration of CaC12 (experiment 2). After 45 mins, 8 mg/Kg (experiment 3, n=10) and 16 mg/Kg (experiment 4, n=10) of MgSO4 were injected for 5 mins, and than CaCl2 and epinephrine were administrated as experiment 2. The onset and duration of ventricular arrhythmia following each experiment were observed. The results were as follows; 1) 16 ug/Kg of epinephrine induced ventricular arrhythmia in all cases. 2) CaCl2 infusion caused a reduction in onset and increase in duration of epinephrine-induced-arrhythmia, but there was no significanee. 3) MgSO4-pretreatment caused a increase in onset and reduetion in the CaCl2-caused increase in arrhythmia duration. Only MgSO4-16 mg/Kg values were significant. In conclusion, magnesium salts pretreatment demonstrated effectiveness in preventing ventricular arrhythmia associated with epinephrine usage and hypercalcemic condition during halothane anesthesia.
Alcoholism ; Anesthesia ; Arrhythmias, Cardiac* ; Calcium ; Calcium Channel Blockers ; Coronary Artery Disease ; Digitalis ; Epinephrine* ; Halothane ; Magnesium ; Myocardial Ischemia ; Poisoning ; Potassium ; Rabbits ; Salts ; Sodium

OBJECTIVE: To explore the objective evidence of the corpus biochemical changes in rabbits for postmortem diagnosis of potassium intoxication. METHODS: Rabbits were sacrificed by Infusion of 0.3% KCl at full speed push or 1% KCl at 100 drip/min, respectively, with normal rabbits used as control. Cardiac blood and urine samples were collected before and after potassium infusion to examine the concentrations of various electrolytes (K+, Na+, Ca2+, Mg2+, Cl-, and HCO3-) and to observe the antemortem and postmortem biochemical changes. RESULTS: The mean lethal infusion time in the 0.3%KCl group was longer than that in the 1% KCl group (P = 0.006). The serum concentration of K+ increased while the serum concentrations of Na+, Ca2+, Cl-, and HCO3- decreased after the infusion. There were no statistically significant differences in the whole blood concentration of K+ as well as the serum concentration of Mg2+ between the two groups (P = 0.062). There were statistically significant differences in the concentrations of whole blood K+, as well as serum Na+, Mg2+, and Cl-, but not in the serum K+, Ca2+, and HCO3-. There were no statistically significant differences seen in the urine volumes and the concentrations of all the urine electrolytes between the groups. CONCLUSION Examination of the concentrations of K+ both in the whole blood and serum, as well as Mg2+ in the serum may be helpful for postmortem diagnosis of potassium intoxication.
Animals ; Calcium/urine* ; Electrolytes/urine* ; Forensic Medicine/methods* ; Injections, Intravenous/methods* ; Magnesium/urine* ; Male ; Postmortem Changes ; Potassium/poisoning* ; Potassium Chloride/administration & dosage* ; Rabbits ; Sodium/urine*