Effectiveness of abdominal radiographs in visualizing chewable iron supplements following overdose

The purpose of this study was to determine the clinical effectiveness of visualizing chewable and nonchewable iron supplements remaining in the gastrointestinal tract following an overdose. A 5-year retrospective review of 93 pediatric patients who had ingested potentially toxic amounts of an iron supplement found that 58% had abdominal radiographs taken. Fifty-five percent of these patients had ingested chewable multiple vitamins with iron and 40% had ingested nonchewable tablets. After radiographic review, radiopaque densities could be marginally visualized in only one case of ingestion of a chewable iron supplement. The mean serum iron level of patients who had ingested a chewable form of iron was 270 micrograms/dL. An in vitro study was performed to determine the radiopacity of various chewable multiple vitamins with iron. It was concluded that although chewable multiple vitamins with iron are radiopaque in vitro, clinical radiographic visualization is unlikely.