Bowel preparation agent inducing profound shock precolonoscopy

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Colorectal Surgery

Background:

• A 73-year-old woman with a history of severe chronic obstructive pulmonary disease, Crohn's disease, diverticular disease, hypertension, and dyslipidaemia underwent oral bowel preparation for a colonoscopy to investigate haematochezia.

Observation:

• Following bowel preparation, the patient presented with acute onset of vomiting and diarrhoea, necessitating admission to the intensive care unit.

Findings:

• The patient required aggressive resuscitation with intravenous fluids, antibiotics, and vasopressor support, including epinephrine, norepinephrine, and vasopressin infusions.

Implications:

• This case highlights a potential severe complication of oral bowel preparation, emphasizing the need for careful patient selection and monitoring.
• The patient's complex medical history likely contributed to her poor outcome.
• Further research may be warranted to identify risk factors and optimize bowel preparation protocols to prevent such adverse events.