Sevelamer-associated ischemic colitis with perforation

We present a case of an 83-year-old woman with end-stage renal disease and hyperphosphatemia treated with sevelamer carbonate, who underwent subtotal colectomy for diffuse bowel necrosis and two perforations in the transverse colon. Histologic examination revealed ischemic colitis with crystals cons...

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Bibliographic Details
Main Authors: Rachel Hudacko, Peter Kaye
Format: Article
Language:English
Published: MDPI AG 2015-12-01
Series:Gastroenterology Insights
Subjects:
Online Access:http://www.pagepress.org/journals/index.php/gi/article/view/6116
Description
Summary:We present a case of an 83-year-old woman with end-stage renal disease and hyperphosphatemia treated with sevelamer carbonate, who underwent subtotal colectomy for diffuse bowel necrosis and two perforations in the transverse colon. Histologic examination revealed ischemic colitis with crystals consistent with sevelamer carbonate embedded in ulcer debris and within the colonic wall in areas of transmural necrosis. This is a novel cause of drug-induced ischemic colitis with subsequent perforation that has not yet been reported in the literature. Clinicians and pathologists should be aware of the potential complications of sevelamer use and the histologic features of sevelamer-induced colonic injury.
ISSN:2036-7414
2036-7422