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KMID : 0882420130840040591
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Korean Journal of Medicine
2013 Volume.84 No. 4 p.591 ~ p.596
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Case of Acute Colonic Pseudo-Obstruction Combined with Rhabdomyolysis induced by Severe Hypokalemia
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Lee Woo-Hyun
Lee Da-Young
Seo Ji-Ho
Kang Gun-Woo
Kwon Joong-Goo
Lee In-Hee
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Abstract
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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.
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KEYWORD
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Hypokalemia, Colonic pseudo-obstruction, Rhabdomyolysis
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