A Case of Acute Colonic Pseudo-Obstruction Combined with Rhabdomyolysis induced by Severe Hypokalemia.
- Author:
Woo Hyun LEE
1
;
Da Young LEE
;
Ji Ho SEO
;
Gun Woo KANG
;
Joong Goo KWON
;
In Hee LEE
Author Information
1. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. ihlee@cu.ac.kr
- Publication Type:Case Report
- Keywords:
Hypokalemia;
Colonic pseudo-obstruction;
Rhabdomyolysis
- MeSH:
Abdominal Pain;
Colon;
Colon, Descending;
Colon, Transverse;
Colonic Pseudo-Obstruction;
Colonoscopy;
Creatine Kinase;
Dilatation;
Gastrointestinal Motility;
Humans;
Hypertension;
Hypokalemia;
Injections, Intravenous;
Intestines;
Male;
Myoglobin;
Neostigmine;
Potassium;
Rhabdomyolysis
- From:Korean Journal of Medicine
2013;84(4):591-596
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acute colonic pseudo-obstruction (ACPO) or Ogilvie's syndrome is a rare disorder of intestinal motility characterized by massive colonic dilatation without mechanical obstruction. We report a case of ACPO combined with rhabdomyolysis induced by severe hypokalemia. A 78-year-old male with a 10-year history of hypertension presented with abdominal pain and distension for 2 days. The laboratory findings showed hypokalemia with markedly elevated serum creatine phosphokinase and myoglobin levels. A plain abdominal x-ray revealed a markedly distended ascending and transverse colon with a cut-off sign at the descending colon. Mechanical obstruction of the intestine was excluded by computed tomography and colonoscopy. He was initially treated with supportive therapy, including insertion of a rectal tube and intravenous fluids with potassium replacement. However, the ACPO persisted, and neostigmine was administered in two separate 2.0-mg intravenous injections, 24 hours apart. Subsequently, the abdominal pain and colonic distension were relieved.
