We report quadriparesis as a result of severe hypokalaemia and acidosis in a 50-year-old man who had undergone ureterosigmoidostomy for bladder extrophy 48 years earlier. Aggressive suppletion with intravenous potassium and bicarbonate combined with potassium-sparing diuretics and ACE inhibitors resulted in complete restoration of the serum potassium and resolution of the neurological symptoms. The underlying mechanism as well as the treatment of hypokalaemia and hyperchloraemic metabolic acidosis after ureterosigmoidostomy are briefly discussed.

Acidosis, Renal Tubular/complications/diagnosis, Anastomosis, Surgical, Bicarbonates/administration & dosage, Bladder Exstrophy/complications/diagnosis/*surgery, Chlorides/administration & dosage, Colon, Sigmoid/*surgery, Critical Illness, Humans, Hypokalemia/diagnosis/drug therapy/*etiology, Infusions, Intravenous, Magnesium Sulfate/administration & dosage, Male, Middle aged, Potassium/administration & dosage, Prognosis, Quadriplegia/diagnosis/*etiology/therapy, Reconstructive Surgical Procedures/*adverse effects/methods, Risk Assessment, Severity of Illness Index, Treatment Outcome, Ureter/*surgery
hdl.handle.net/1765/9923
The Netherlands Journal of Medicine
Erasmus MC: University Medical Center Rotterdam

van Bekkum, J.W, Bac, D.J, Nienhuis, I.E, Dees, A, & de Leeuw, P.W. (2002). Life-threatening hypokalaemia and quadriparesis in a patient with ureterosigmoidostomy. The Netherlands Journal of Medicine. Retrieved from http://hdl.handle.net/1765/9923