Cation Exchange Resins and XXXX . What surgeons need to know.

@entity1 @entity39 @entity25210 @entity5121 @entity4 @entity1066 @entity694 @entity1049 @entity740 @entity8307 @entity490 @entity972 @entity14957 @entity1142 @entity4144
INTRODUCTION: Since 1961 the use of Cation Exchange Resins has been the mainstream treatment for @entity4144 . For the past 25 years different kind of complications derived from its clinical use have been recognized, being the @entity39 the most feared and lethal of all. PRESENTATION OF CASE: We report a case of a 72-year-old @entity1 with @entity740 , treated with @entity25210 for @entity4144 treatment who presented in the emergency department with @entity1142 treated with hypertonic cathartics. With clinical deterioration 48h later progressed with @entity39 requiring urgent laparotomy, sigmoidectomy and open abdomen management with subsequent rectal stump perforation and dead. The histopathology finding: @entity25210 embedded in the mucosa, consistent with the cause of perforation. DISCUSSION: Lillemoe reported the first case series of five uremic @entity1 with @entity694 associated with the use of @entity14957 in @entity5121 in 1987 and in 2009 the FDA removed from the market the @entity14957 containing 70% of @entity5121 . The pathophysiologic change of CER goes from @entity4 , @entity1066 , @entity8307 , and the most severe case transmural @entity39 . Up to present day, some authors have questioned the use of CER in the setting of lowering serum @entity972 . Despite its worldwide use in @entity4144 settings, multiple studies have not demonstrated a significant @entity972 excretion by CER. CONCLUSION: Despite the low incidence of @entity1049 and lethal @entity39 associated with the CER clinical use, the general surgeon needs a high index of suspicion when dealing with @entity1 treated with CER and @entity490 .
