Fecal loading and phosphate binders

Case contributed by Dr Dion Athiththan Paul

Presentation

Urinary frequency and right sided flank pain with constipation

Patient Data

Age: 80 years
Gender: Female

There is a pacemaker present. There is a small right sided pleural effusion with associated consolidation. Mild cardiomegaly is noted. There is moderate fecal loading with high density material likely representing phosphate binding agents.

Case Discussion

Key Learning Points:

- late stage chronic kidney disease (CKD) patients will often have an extensive medication history with various binding agents.

- in the context of constipation, these binding agents (especially phosphate) can appear on plain films as high density material peppered throughout the fecal matter.

Case courtesy of Dr. Angus Chew & Dr. Angela Wu

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