Milk Alkali Syndrome Complicated by Calcium Impaction Causing Bowel Perforation

Abstract

The milk-alkali syndrome consists of hypercalcemia, metabolic alkalosis, and acute kidney injury associated with the ingestion of large amounts of calcium and absorbable alkali. There has been a resurgence of this condition because of calcium therapy for prevention and treatment of osteoporosis, easy access to over-the-counter calcium carbonate preparations, and use of calcium carbonate to minimize secondary hyperparathyroidism in patients with chronic kidney disease. We report a rare patient case of severe milk-alkali syndrome resulting in hemodynamic instability and multiple metabolic derangements with severe intestinal obstruction in the setting of fecal impaction.