Amphojeloma: antacid impaction in a critically ill patient

Patients in the intensive care unit seldom have mechanical small-bowel obstruction, and obstruction due to medication bezoars is even less common. A 65-year-old woman, in the intensive care unit because of septic shock and acute renal failure, had a small-bowel obstruction due to Amphojel concretions. Obstruction from such a cause may be prevented by including non-constipating antacids, stool softeners or sorbitol. Aggressive use of H2-antagonists to prevent gastrointestinal bleeding in septic patients will reduce the need for orally administered antacids. When obstruction occurs due to antacid concretions, it may be relieved by passing a long intestinal tube, by giving enemas for colonic obstruction or by operation.