A Case of Hypermagnesemia and Large Bowel Obstruction Following Magnesium Citrate Administration

Abstract

Hypermagnesemia is often caused by the excessive administration of preparations containing magnesium (Mg) in patients with renal dysfunction. We report a case of a patient who developed hypermagnesemia and large bowel obstruction following administration of Mg citrate (Magcorol P®). The patient was a 66-year-old woman, scheduled to undergo a barium enema examination to determine the cause of anal pain and constipation. Upon oral administration of Mg citrate as pretreatment, the patient started vomiting and exhibited altered consciousness, and was transferred to the emergency outpatient department of our hospital. Close examination revealed hypermagnesemia and fecal large bowel obstruction, so emergency hemodialysis was performed. The following day, re-elevation of the Mg levels and worsening of the large bowel obstruction were observed. An emergency sigmoid colostomy was therefore performed. After surgery, serum Mg concentration normalized rapidly. Reports have appeared on patients who have developed severe hypermagnesemia upon administration of Mg citrate preparations in the absence of renal dysfunction. Because severe hypermagnesemia can be fatal, due care and guidance should be provided to patients during Mg citrate administration, and prompt treatment is important if hypermagnesemia develops.