The Safety of Glucagon use during ERCP in Diabetic Patients with Renal Insufficiency: A Case Discussion and Review of Literature

  • Lisa Erlinger, PhD, CRNA Midwestern University Wickenburg Community Hospital University of Missouri-Columbia
  • Terri Monk, MD, MS University of Missouri-Columbia
  • Steven McAfee, MD University of Missouri-Columbia


This is a case report with the use of glucagon during ERCP which resulted in Hyperkalemia.  A 45 year old male, ASA 3, with Type 1 diabetes mellitus, hypertension, and chronic kidney disease underwent ERCP with general anesthesia for evaluation of a bile duct stricture.  After administration of 0.75 mg glucagon (0.25 mg doses over an hour) tall, peaked T-waves were noted on the ECG. Labs were drawn and potassium was 6.6 mEq/L and glucose was 393 mg/dL. Intravenous calcium chloride, 1000 mg, was titrated.  Repeat potassium was 6.1mEq/L and glucose 568 mg/dL.  The remainder of the procedure was uneventful and postoperative potassium was 5.2 mEq/dL.  

Author Biographies

Lisa Erlinger, PhD, CRNA, Midwestern University Wickenburg Community Hospital University of Missouri-Columbia

Assistant Professor MidWestern University-St. Louis University, Director of Surgical and Anesthesia Services Wickenburg Community Hospital

Terri Monk, MD, MS, University of Missouri-Columbia

Professor of Clinical Anesthesiology University of Missouri

Steven McAfee, MD, University of Missouri-Columbia

Anesthesiologist University of Missouri-Columbia


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How to Cite
ERLINGER, PHD, CRNA, Lisa; MONK, MD, MS, Terri; MCAFEE, MD, Steven. The Safety of Glucagon use during ERCP in Diabetic Patients with Renal Insufficiency: A Case Discussion and Review of Literature. Anesthesia eJournal, [S.l.], v. 6, p. 33-36, nov. 2018. ISSN 2333-2611. Available at: <>. Date accessed: 19 aug. 2022.


: ERCP, Glucagon, Diabetic, Renal insufficiency, Hyperkalemia