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Colonic Necrosis with Kayexalate-Sorbitol Enemas after Renal Transplantation

F. Taylor Wootton, MD; David F. Rhodes, MD; William M. Lee, MD; and C. Thomas Fitts, MD
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Requests for Reprints: F. Taylor Wootton, MD, Gastroenterology Division, University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425.

Current Author Addresses: Drs. Wootton, Rhodes, and Lee: Gastroenterology Division, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425.

Dr. Fitts: Department of Surgery, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425.

Ann Intern Med. 1989;111(11):947-949. doi:10.7326/0003-4819-111-11-947
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This excerpt has been provided in the absence of an abstract.

Gastrointestinal complications are common in uremia and after renal transplantation. Why intestinal necrosis, a catastrophic event in renal transplantation, occurs is unclear. In many instances, colonic injury does not appear to be a direct result of mesenteric vascular compromise. We report a case of unexplained colonic necrosis in a renal transplant recipient occurring less than 24 hours after he had received four enemas with sodium polystyrene sulfonate suspension (Kayexalate, Roxane Laboratories, Columbus, Ohio) in sorbitol for hyperkalemia. This severe complication may be a direct result of the use of such enemas.

Case Report

A 48-year-old white man with end-stage renal


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