We report a 650 g, 24 week hyperkalemic newborn who developed both cecal impaction
and perforation after treatment with sodium polystyrene sulfonate enemas. Flat plate
abdominal radiographs revealed impacted resin as a radiodense material outlining the
bowel. Pathological examination showed sodium polystyrene sulfonate crystals contained
in the cecal abscess. Review of the literature in both adults and children leads us
to conclude that the use of this sodium-potassium exchange resin for the treatment
of hyperkalemia in this gestational age group is probably not helpful for decreasing
serum potassium and may be detrimental to the infant.
Hyperkalemia - cecal perforation - sodium polystyrene sulfonate enema
