{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:03Z","timestamp":1756379403826,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,25]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>Spinal cord injury (SCI) is associated with a range of secondary health issues. Altered neurological function can complicate diagnosis, which may have serious consequences. Here we present the case of a tetraplegic person presenting with confusion and bradycardia. Initial testing revealed severe hyponatraemia (sodium 96\u2009mmol\/L) and ST elevation associated with labile blood pressure. Delayed further investigation identified sigmoid volvulus\u2014endoscopic decompression led to resolution of haemodynamic lability and a diagnosis of autonomic dysreflexia. Low mood and poor documentation in the community were found to contribute to poor compliance with an established bowel management plan. Inpatient care involved electrolyte correction and establishment of regular bowel motions. The patient was discharged at baseline neurology with psychological support. This case highlights poor awareness of the secondary health issues affecting those with SCI and the complex relationship between mental and physical health.<\/jats:p>","DOI":"10.1136\/bcr-2018-228209","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T07:35:11Z","timestamp":1560324911000},"page":"e228209","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Severe hyponatraemia and autonomic dysreflexia in a quadriplegic person"],"prefix":"10.1136","volume":"12","author":[{"given":"Roshan","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Malliwal","sequence":"additional","affiliation":[{"name":"Department of Radiology, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"2025082803321284000_12.6.e228209.1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.8-1-70"},{"key":"2025082803321284000_12.6.e228209.2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-13-1020"},{"key":"2025082803321284000_12.6.e228209.3","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/00000441-198911000-00011","article-title":"Severe hyponatremia in spinal cord injury","volume":"298","author":"Sica","year":"1989","journal-title":"Am J Med Sci"},{"key":"2025082803321284000_12.6.e228209.4","first-page":"509","article-title":"Total body water and its distribution in men with spinal cord injury","volume":"65","author":"Card\u00fas","year":"1984","journal-title":"Arch Phys Med Rehabil"},{"key":"2025082803321284000_12.6.e228209.5","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101984"},{"key":"2025082803321284000_12.6.e228209.6","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1080\/01952307.1990.11735824","article-title":"Hyponatremia in spinal cord injury","volume":"13","author":"Sica","year":"1990","journal-title":"J Am Paraplegia Soc"},{"key":"2025082803321284000_12.6.e228209.7","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1089\/neu.2016.4573","article-title":"Characterizing the severity of autonomic cardiovascular dysfunction after spinal cord injury using a novel 24 hour ambulatory blood pressure analysis software","volume":"34","author":"Popok","year":"2017","journal-title":"J Neurotrauma"},{"key":"2025082803321284000_12.6.e228209.8","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2004.024463"},{"key":"2025082803321284000_12.6.e228209.9","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1016\/j.rehab.2013.07.453","article-title":"Sigmoid volvulus in a patient with spinal cord injury: a clinical case and review of the literature","volume":"56","author":"Trenson","year":"2013","journal-title":"Ann Phys Rehabil Med"},{"key":"2025082803321284000_12.6.e228209.10","first-page":"393","article-title":"Colonic volvulus in the spinal cord injured patient","volume":"31","author":"Fenton-Lee","year":"1993","journal-title":"Paraplegia"},{"key":"2025082803321284000_12.6.e228209.11","doi-asserted-by":"crossref","first-page":"16030","DOI":"10.1038\/scsandc.2016.30","article-title":"Coronary vasospasm in intractable autonomic dysreflexia","volume":"2","author":"Tan","year":"2016","journal-title":"Spinal Cord Ser Cases"},{"key":"2025082803321284000_12.6.e228209.12","doi-asserted-by":"publisher","DOI":"10.1080\/00048670801886080"},{"key":"2025082803321284000_12.6.e228209.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)91487-7"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:32:17Z","timestamp":1756377137000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":13,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,11]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/bcr-2018-228209"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228209","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}