Impaired consciousness due to hypermagnesemia associated with stercoral
colitis: report of a rare case

Impaired consciousness due to hypermagnesemia associated with stercoral
colitis: report of a rare case

Colitis, Constipation, Hypermagnesemia, Impaired consciousness, Intestinal dysfunction, Magnesium
containing cathartics, Obstructive colitis

Abstract
Background Hypermagnesemia is a rare electrolyte abnormality that is difficult to diagnose because its symptoms
are nonspecific. In addition to magnesium administration, renal dysfunction is often a major risk factor associated with
the condition; severe intestinal dysfunction is also a known risk factor. However, no cases of hypermagnesemia were
observed in the absence of magnesium administration.
Case presentation A 75-year-old woman with cognitive impairment presented to the emergency department
with impaired consciousness. The patient was comatose and hypotensive and had a markedly distended abdomen.
Her blood pressure was stabilized with infusion; however, the improvement in consciousness was insufficient
and somnolence continued. Abdominal computed tomography revealed marked colonic distension due to fecal
impaction in the rectum, with wall thickening and pericolonic fat stranding. Blood tests revealed elevated levels of
C-reactive protein (10.2 mg/dL), lactate (6.04 mmol/L), and magnesium (5.9 mg/dL). There was no history of ingestion
of magnesium-containing preparations; thus, the patient was diagnosed with hypermagnesemia associated with
stercoral colitis. Magnesium levels and consciousness improved with the administration of calcium preparations,
diuretics, antibiotics, and defecation control.
Conclusions Severe bowel dysfunction can cause hypermagnesemia, even in the absence of magnesium
administration.
Keywords Colitis, Constipation, Hypermagnesemia, Impaired consciousness, Intestinal dysfunction, Magnesium
containing cathartics, Obstructive colitis

Kana Yanagisawa1

, Daisuke Mizu1*, Hidenori Higashi1

, Masataka Miyamoto1

and Mika Nagatomo1

https://doi.org/10.1186/s12245-025-00838-y

2025

Peri Irawan

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