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Hypermagnesemia-induced paralytic ileus
J Golzarian1, H W Scott, W O Richards
1Department of Surgery, Department of Veterans Affairs Medical Center, Nashville, Tennessee.
Digestive Diseases and Sciences
|May 1, 1994
Summary
Hypermagnesemia, or high magnesium levels, can cause paralytic ileus, a condition where the intestines stop working. This report details two adult cases, highlighting a previously underrecognized gastrointestinal complication of hypermagnesemia.
Area of Science:
- Gastroenterology
- Nephrology
- Internal Medicine
Background:
- Hypermagnesemia is a known cause of hypotension and cardiac dysfunction.
- Paralytic ileus is an underrecognized gastrointestinal complication of hypermagnesemia.
Observation:
- Two adult patients presented with paralytic ileus after ingesting magnesium-containing substances.
- Patient 1: 65-year-old female with normal renal function consumed magnesium citrate and milk of magnesia.
- Patient 2: 67-year-old female with mild renal insufficiency consumed Epsom salts for constipation.
Findings:
- Both patients experienced resolution of paralytic ileus as serum magnesium levels decreased.
- Diagnostic workup, including colonoscopy and imaging studies, ruled out mechanical obstruction.
- These cases, along with one prior report, strongly suggest a causal link between hypermagnesemia and paralytic ileus.
Implications:
- Clinicians should consider hypermagnesemia in patients presenting with unexplained paralytic ileus, especially after magnesium ingestion.
- Recognition of this association can lead to timely diagnosis and management, preventing potential complications.
- Further research is warranted to elucidate the precise mechanisms of hypermagnesemia-induced intestinal dysmotility.