Magnesium Toxicity-Induced Ileus in a Postpartum Patient Treated for Preeclampsia With Magnesium Sulphate

Hypermagnesemia is a rare and under-recognized cause of paralytic ileus. We report a case of a 21-year-old primigravida who was managed aggressively for preeclampsia and presented with postpartum paralytic ileus. Detailed history was employed to consider hypermagnesemia-induced ileus as the working diagnosis, and the patient improved with correction of the electrolyte imbalance. Hypermagnesemia-induced lethargy, decreased reflexes, muscle weakness, flaccid paralysis, respiratory muscle paralysis, and cardiac arrest are well-described; however, intestinal smooth muscle dysfunction leading to paralytic ileus has never been reported in the setting of magnesium use for peripartum preeclampsia management.