2021 Volume 41 Issue 1 Pages 33-36
A 70-year-old man with end-stage renal disease as a complication of diabetes mellitus, who had been on hemodialysis for 17 years, was admitted to our hospital with the complaint of lower abdominal pain and elevated serum CRP levels. He was receiving sevelamer hydrochloride as treatment for the control of hyperphosphatemia associated with chronic kidney disease. Abdominal CT revealed an intestinal diverticulum and intra-abdominal free air. Perforation of the intestinal diverticulum was suspected and emergency laparotomy was carried out. During surgery, several diverticula were found in the jejunum, with one of them having perforated and penetrated into the mesenterium. Partial resection of the jejunum was performed. The patient showed a good postoperative course, and was discharged 18 days after the operation. We report a case of a hemodialysis patient who developed jejunal perforation while taking sevelamer hydrochloride for the control of hyperphosphatemia. Patients on sevelamer hydrochloride should be carefully monitored for the development of any abdominal symptoms.
