%0 Journal Article
%T An Uncommon Potentially Fatal Complication in a Patient without Predisposing Factor Following Oral Bowel Preparation Commonly Used for Colonoscopy
%A Iris Wai Sum Li
%A Ling Pong Leung
%A Sik Hon Tsui
%J Open Journal of Emergency Medicine
%P 6-10
%@ 2332-1814
%D 2016
%I Scientific Research Publishing
%R 10.4236/ojem.2016.41002
%X 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.
%K Symptomatic Hypocalcaemia
%K Hyperphosphatemia
%K Sodium Phosphate Solution
%K Bowel
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=64780