Five days of whole-bowel irrigation in a case of pediatric iron ingestion

Ann Emerg Med. 1996 Feb;27(2):258-63. doi: 10.1016/s0196-0644(96)70334-7.

Abstract

The maximum duration and volume of polyethylene glycol electrolyte solution (PEG-ELS) that can be safely administered during whole-bowel irrigation of the poisoned patient are poorly defined. We present a case of a 33-month-old boy who ingested at least 160 mg/kg elemental iron and received 44.3 L of PEG-ELS (2,953 ml/kg) over 5 days because of the persistence of iron tablets in teh gastrointestinal tract. The child remained clinically well after initiation of PEG-ELS therapy, and further significant iron absorption did not appear to occur. The rectal effluent cleared within 2 days of the start of PEG-ELS therapy despite the persistence of iron in the gastrointestinal tract as shown on radiography. No adverse effects resulted from teh large volume or duration of the PEG-ELS therapy. This is the greatest reported volume of PEG-ELS to be used for whole-bowel irrigation in the treatment of a toxic ingestion.

Publication types

  • Comparative Study

MeSH terms

  • Child, Preschool
  • Colon
  • Electrolytes / administration & dosage*
  • Ferrous Compounds / poisoning*
  • Humans
  • Male
  • Poisoning / diagnostic imaging
  • Poisoning / therapy
  • Polyethylene Glycols / administration & dosage*
  • Radiography, Abdominal
  • Therapeutic Irrigation / methods*
  • Time Factors

Substances

  • Electrolytes
  • Ferrous Compounds
  • Polyethylene Glycols