Refractory Hypokalemia in Secretory Diarrhea Phenotype of Colonic Pseudo-Obstruction (Ogilvie's Syndrome)

Colonic pseudo-obstruction is an acute non-obstructive colonic dilation associated with constipation or secretory diarrhea. The secretory diarrhea phenotype is associated with refractory hypokalemia that may require different interventions to treat. We present a case of a 51-year-old male who was ad...

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Published inCurēus (Palo Alto, CA) Vol. 14; no. 11; p. e32026
Main Authors Hazzazi, Ahmad A, Aloyouny, Saleh H, Saleem, Akbar
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 29.11.2022
Cureus
Subjects
Abdomen
Bone surgery
Case reports
Colon
Diarrhea
Electrolytes
Gastroenterology
Hypokalemia
Internal Medicine
Mortality
Other
Pathophysiology
Patients
Potassium
Urine
refractory
secretory diarrhea
colonic pseudo-obstruction
hypokalemia
ogilvie's syndrome
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Summary:Colonic pseudo-obstruction is an acute non-obstructive colonic dilation associated with constipation or secretory diarrhea. The secretory diarrhea phenotype is associated with refractory hypokalemia that may require different interventions to treat. We present a case of a 51-year-old male who was admitted with a hemorrhagic stroke whose hospital course was complicated by severe abdominal distension, diarrhea, and hypokalemia. Initial investigations excluded infectious causes. Imaging confirmed colonic pseudo-obstruction. The hypokalemia was severe and refractory, requiring daily potassium replacement along with rectal tube decompression and spironolactone. Despite these interventions, the hypokalemia persists and requires nearly 100 days to resolve completely.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.32026