Emergency gastrotomy for acute iron poisoning

A 15-month-old girl who ingested an estimated 80 mg/kg to 100 mg/kg of elemental iron was treated in the emergency department for acute iron poisoning. Attempts to evacuate the stomach using emesis and gastric lavage were ineffective. Abdominal radiographs confirmed the presence of large, iron-containing aggregates in the stomach. An emergency gastrotomy was required to remove this potentially lethal dose of iron. During surgery the iron was noted to be embedded in the gastric mucosa, explaining its previous resistance to conventional stomach-emptying methods.