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Acute Gastric Injury Caused by Undissolved Sodium Picosulfate/Magnesium Citrate Powder

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Sodium picosulfate/magnesium citrate (SPMC) is a widely used oral bowel cleansing agent considered to be relatively safe. However, partially dissolved or undissolved SPMC powder may cause severe injuries of the esophagus and stomach. We report a very rare case of acute gastric injury without esophageal damage caused by the ingestion of undissolved SPMC powder. A 69-year-old man experienced epigastric pain after swallowing SPMC powder without dissolving it in water in preparation for a screening colonoscopy. He realized his mistake immediately and subsequently drank 2 L of water. The esophagogastroduodenoscopy conducted after 12 hours indicated an acute gastric ulceration without injury of the esophagus or duodenum. The endoscopy conducted after 6 weeks of oral proton pump inhibitor treatment showed healing of the gastric injury. This suggested that drinking large amounts of water after ingesting partially dissolved or undissolved SPMC powder can prevent serious esophageal injury, but offers no preventive benefit for acute gastric injury.

Abstract

Sodium picosulfate/magnesium citrate (SPMC) is a widely used oral bowel cleansing agent considered to be relatively safe. However, partially dissolved or undissolved SPMC powder may cause severe injuries of the esophagus and stomach. We report a very rare case of acute gastric injury without esophageal damage caused by the ingestion of undissolved SPMC powder. A 69-year-old man experienced epigastric pain after swallowing SPMC powder without dissolving it in water in preparation for a screening colonoscopy. He realized his mistake immediately and subsequently drank 2 L of water. The esophagogastroduodenoscopy conducted after 12 hours indicated an acute gastric ulceration without injury of the esophagus or duodenum. The endoscopy conducted after 6 weeks of oral proton pump inhibitor treatment showed healing of the gastric injury. This suggested that drinking large amounts of water after ingesting partially dissolved or undissolved SPMC powder can prevent serious esophageal injury, but offers no preventive benefit for acute gastric injury.

참고문헌 (6)

  1. Muñoz-Navas M, "A randomized trial to compare the efficacy and tolerability of sodium picosulfate-magnesium citrate solution vs. 4 L polyethylene glycol solution as a bowel preparation for colonoscopy", Int J Colorectal Dis, 30, pp.1407~1416 (2015)
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  3. 서재영, "Corrosive Esophagitis Caused by Ingestion of Picosulfate", Clinical Endoscopy, 48(1), pp.66~69 (2015), 대한소화기내시경학회
  4. Suh JP, "Education and imaging. Gastroenterology:acute mucosal injury of esophagus and stomach induced by sodium picosulfate", magnesium citrate for bowel preparation, 2014, pp.29, 1571~
  5. Portalatin M, "Medical management of constipation", Clin Colon Rectal Surg, 25, pp.12~19 (2012)
  6. Ramasamy K, "Corrosive ingestion in adults", J Clin Gastroenterol, 37, pp.119~124 (2003)

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