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Five days of whole-bowel irrigation in a case of pediatric iron ingestion

J M Kaczorowski1, P M Wax

  • 1Department of Pediatrics, University of Rochester School of Medicine, New York, USA.

Annals of Emergency Medicine
|February 1, 1996
PubMed

Insights

This case study shows that high volumes of polyethylene glycol electrolyte solution (PEG-ELS) can be safely used for whole-bowel irrigation in pediatric iron poisoning. The treatment effectively cleared the gastrointestinal tract without adverse effects.

Area of Science:

  • Toxicology
  • Gastroenterology
  • Emergency Medicine

Background:

  • The safe limits for polyethylene glycol electrolyte solution (PEG-ELS) in whole-bowel irrigation for poisoned patients are not well-established.
  • Whole-bowel irrigation is a decontamination procedure used in toxicology.

Purpose of the Study:

  • To report a case of a pediatric patient who received an exceptionally large volume and duration of PEG-ELS for iron poisoning.
  • To assess the safety and efficacy of high-volume PEG-ELS therapy in this context.

Main Methods:

  • A 33-month-old boy ingested a significant amount of elemental iron.
  • The patient underwent whole-bowel irrigation with 44.3 L of PEG-ELS over 5 days due to persistent iron tablets in the GI tract.
  • Clinical status, iron absorption, and rectal effluent were monitored.

Main Results:

  • The child tolerated the large volume (44.3 L, 2,953 ml/kg) and duration (5 days) of PEG-ELS without adverse effects.
  • Rectal effluent cleared within 2 days, indicating successful gastrointestinal decontamination.
  • No further significant iron absorption was observed despite persistent radiopaque material.

Conclusions:

  • This case demonstrates that extensive volumes and durations of PEG-ELS can be safely administered for whole-bowel irrigation in pediatric iron poisoning.
  • High-volume PEG-ELS therapy can be effective in managing persistent gastrointestinal contamination in toxic ingestions.

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