Cecal perforation associated with sodium polystyrene sulfonate-sorbitol enemas in a 650 gram infant with hyperkalemia.

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.