A Case of Ileus after Taking Polycarbophil Calcium

We report a case of operated ileus in a 67-year-old woman who underwent an operation for a right ovarian cyst, after taking polycarbophil calcium drugs. She was admitted for abdominal fullness and vomiting. Twelve days before admission, she took polycarbophil calcium drugs prescribed by a primary care physician for 7 days due to diarrhea. Abdominal computed tomography (CT) showed expansion of the small intestine with feces. At first she was managed with an intestinal decompression long tube. However, 4 days later, the abdominal pain became worse, ascites was found by CT examination and laparotomy was performed. After lysis of adhesions, filling feces in the expanded small intestine were hard to pass through to the anal side, therefore feces were removed by cutting the intestinal wall. The intraperitoneal adhesions delayed intestinal transit. The calcium polycarbophil caused more swelling and hardening in the small intestine. We believe this operated ileus was caused by the adhesions and this drug. We discuss our case in light of a review of the literature.