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Fatal acute sodium phosphate enemas intoxication
1Department of Internal Medicine Nahariya Hospital, B Rappaport Faculty of Medicine, Technion, Nahariya, Israel. raymondfarah@hotmail.com
Acta Gastro-Enterologica Belgica
|November 5, 2005
Summary
Severe hypocalcemia and hyperphosphatemia can occur after sodium-phosphate enema use, leading to patient death. Healthcare providers should exercise caution, particularly with elderly patients, even when using standard doses.
Area of Science:
- Nephrology
- Gastroenterology
- Internal Medicine
Background:
- Sodium-phosphate enemas are commonly used for bowel preparation.
- Electrolyte disturbances can occur following enema administration.
Observation:
- A case of a patient experiencing severe hypocalcemia and hyperphosphatemia after receiving a sodium-phosphate enema is presented.
- The patient exhibited no overt signs of renal failure prior to the event.
Findings:
- The patient's death was directly attributed to the severe electrolyte imbalances (hypocalcemia and hyperphosphatemia).
- These adverse events occurred despite the administration of a sodium-phosphate enema, even at standard dosages.
Implications:
- Physicians must be vigilant regarding the potential risks associated with sodium-phosphate enemas, including in patients without apparent renal impairment.
- Increased awareness and careful patient selection are crucial to prevent potentially fatal outcomes from these commonly used agents, especially in the elderly population.