An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the ProstateReportar como inadecuado




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Case Reports in Surgery - Volume 2017 2017, Article ID 2394365, 4 pages - https:-doi.org-10.1155-2017-2394365

Case Report

Department of Hepatobiliary Surgery, Royal Free Hospital, Pond Street, London NW3 2QG, UK

Department of Paediatrics, Eastbourne District General Hospital, Eastbourne BN21 2UD, UK

Department of Transplantation, Leicester General Hospital, Leicester LE5 4PW, UK

Department of General Surgery, St Helier Hospital, Carshalton SM5 1AA, UK

Correspondence should be addressed to Umasankar Mathuram Thiyagarajan

Received 29 July 2016; Revised 14 February 2017; Accepted 20 February 2017; Published 13 March 2017

Academic Editor: Makoto Ohori

Copyright © 2017 Umasankar Mathuram Thiyagarajan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Neuroendocrine Carcinoma of the Prostate NECP is rare and only few cases have been reported, constituting less than 0.5% of prostatic malignancies. We report a rare case of large bowel obstruction from NECP posing a further challenge in management due to resistant hypokalaemia. A 70-year-old man presented with clinical signs of large bowel obstruction who was known to have prostatic carcinoma three years ago, treated initially with hormone therapy then chemoradiation. The blood profile showed a severe hypokalaemia and CT scan revealed liver and lung metastases apart from confirming large bowel obstruction from local invasion of NECP. Severe hypokalaemia was believed to be caused by paraneoplastic syndrome from tumor burden or by recent administration of Etoposide. Intensive potassium correction through a central venous access in maximal doses of 150 mmol-24 hours under cardiac monitoring finally raised serum potassium to 3.8 mmol-L. This safe period allowed us to perform a trephine colostomy at the left iliac fossa. The postoperative period was relatively uneventful. This first case report is presenting a rare cause of large bowel obstruction from a neuroendocrine carcinoma of prostate and highlights the importance of an early, intensive correction of electrolytes in patients with large tumor burden from NECP.





Autor: Umasankar Mathuram Thiyagarajan, A. Ponnuswamy, A. Bagul, and A. Gupta

Fuente: https://www.hindawi.com/



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