Gastrotomy and whole bowel irrigation in iron poisoning

Ipecac and gastric lavage are questionable interventions for the overdose patient, and activated charcoal does not absorb iron. Gastrotomy and whole bowel irrigation have been described as unique interventions for this poisoning. We describe a patient who was treated with each of these. Because less than half of the iron was removed during surgery, and because the chelation requirement was modest, it is likely that whole bowel irrigation removed a significant amount of iron. We believe that this combined approach contributed to our patient's positive outcome.