{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:55:05Z","timestamp":1764251705656,"version":"3.41.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T00:00:00Z","timestamp":1619222400000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We present the case of a 23-year-old patient who developed a severe gastric ischemia after the ingestion of a single dose of sodium polystyrene sulfonate (SPS) orally. Emergency surgery confirmed extensive full thickness gastric necrosis, prompting a total gastrectomy. Histopathology showed kayexalate crystals in the gastric wall, suggesting SPS-related ischemic gastritis. After radical resection of the affected stomach, this young patient was able to fully recover. Although effective, the widespread use of SPS to treat hyperpotassemia remains a debated topic because of rare but serious adverse events like the forming of kayexalate crystal residues in the gastrointestinal tract. These crystal residues are mostly found in the large intestine and can lead to ulceration and necrosis. Physicians need to be aware of this rare but potentially devastating adverse effect of SPS ingestion.<\/jats:p>","DOI":"10.1093\/jscr\/rjab135","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T20:10:06Z","timestamp":1616011806000},"source":"Crossref","is-referenced-by-count":3,"title":["Small crystals with severe consequences"],"prefix":"10.1093","volume":"2021","author":[{"given":"Jennifer M","family":"Klasen","sequence":"first","affiliation":[{"name":"Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caspar J","family":"Peterson","sequence":"additional","affiliation":[{"name":"Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lana L","family":"Fourie","sequence":"additional","affiliation":[{"name":"Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuyana","family":"Boldanova","sequence":"additional","affiliation":[{"name":"Clarunis, Department of Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi M","family":"Terracciano","sequence":"additional","affiliation":[{"name":"Molecular Pathology Division, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Holbro","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otto","family":"Kollmar","sequence":"additional","affiliation":[{"name":"Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,4,24]]},"reference":[{"key":"2021070811411672300_ref1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1177\/1060028016641427","article-title":"Evaluation of sodium polystyrene sulfonate dosing strategies in the inpatient management of hyperkalemia","volume":"50","author":"Mistry","year":"2016","journal-title":"Ann Pharmacother"},{"key":"2021070811411672300_ref2","doi-asserted-by":"crossref","first-page":"4294","DOI":"10.1093\/ndt\/gfs293","article-title":"Asking the question again: are cation exchange resins effective for the treatment of 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