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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
We hereby report the clinical course and treatment strategy for a hyperkalemic patient who developed a severe gastric retention associated with SZC use requiring endoscopic removal.
An 89-year-old Japanese woman with a history of dementia residing in a nursing facility. She developed dyspnea and transferred to the emergency department. Her medical history was significant for a COVID-19 infection in one week before admission, followed by persistent fever. Her condition deteriorated, with an oxygen saturation dropping to the 60s on room air. She was diagnosed with aspiration pneumonia, intubated in the emergency room, and admitted to the intensive care unit for sedation and mechanical ventilation. Laboratory tests revealed hyperkalemia with a potassium (K) level of 6.2 mEq/L. She was treated with 10g of SZC twice daily administered via a nasogastric tube.
By the second hospital day, the patient's K level had improved to 5.0 mEq/L. However, a chest X-ray revealed an abnormal radiopaque shadow in the stomach. As SZC is known to be radiopaque, gastric retention of the agent was suspected. Enteral nutrition was initiated in an attempt to dissolve the residue, but this was unsuccessful. On the fifth hospital day, the hard, clay-like mass of retained SZC was successfully removed via upper gastrointestinal endoscopy. After the procedure, the patient’s overall condition gradually improved, and she was discharged on the 67th day of hospitalization.
Although the radiopacity of SZC is a known property, persistent gastric retention and impaction requiring endoscopic removal are rarely reported. In this case, the retention was likely caused by decreased gastrointestinal motility resulting from sedation and a poor general condition. The use of SZC is expected to increase, as it is generally considered to be safe, even in the patients with a history of ileus. This case suggests that potential for gastric retention should be taken into account when administering SZC to patients with compromised gastrointestinal motility.
Presented at: This abstract was also presented at the 255th Tokai Regional Meeting of the Japanese Society of Internal Medicine.
