Refractory Hypokalemia in Secretory Diarrhea Phenotype of Colonic Pseudo-Obstruction (Ogilvie's Syndrome).

Colonic pseudo-obstruction is an acute non-obstructive colonic dilation associated with constipation or secretory diarrhea. The secretory diarrhea phenotype is associated with refractory hypokalemia that may require different interventions to treat. We present a case of a 51-year-old male who was admitted with a hemorrhagic stroke whose hospital course was complicated by severe abdominal distension, diarrhea, and hypokalemia. Initial investigations excluded infectious causes. Imaging confirmed colonic pseudo-obstruction. The hypokalemia was severe and refractory, requiring daily potassium replacement along with rectal tube decompression and spironolactone. Despite these interventions, the hypokalemia persists and requires nearly 100 days to resolve completely.

Translocation of malpositioned posterior chamber intraocular lens from anterior to posterior chamber along with fibrin glue-assisted transscleral fixation.

PURPOSE: A posterior chamber intraocular lens (PCIOL) wrongly placed in anterior chamber (AC) can lead to progressive endothelial loss and damage to angle structures. We describe a sutureless, closed-chamber translocation technique to maneuver a PCIOL from AC into the PC and fixate it transsclerally with fibrin glue in presence of a large posterior capsular rent. METHODS: This is a prospective interventional case series. The participants were three cases of PCIOL in AC with high intraocular pressure and poor uncorrected visual acuity who underwent the translocation surgery successfully. RESULTS: All cases showed improvement in uncorrected visual acuity, with lowered intraocular pressure and no loss in best spectacle-corrected visual acuity till 6 months follow-up. CONCLUSIONS: This technique prevents a large incision, does not require a special IOL as in transscleral suture fixation, and results in a low endothelial cell loss.