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Related Experiment Videos

Hypocalcemic coma following two pediatric phosphate enemas

J F Sotos, E A Cutler, M A Finkel

    Pediatrics
    |September 1, 1977
    PubMed
    Summary

    Pediatric hypertonic phosphate enemas can cause severe, life-threatening complications like coma and tetany due to electrolyte imbalances. This case highlights the critical need for awareness of these risks in routine medical practice.

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    Area of Science:

    • Pediatric Gastroenterology
    • Clinical Toxicology

    Background:

    • Hypertonic phosphate enemas are commonly used in pediatric practice for constipation.
    • Potential risks associated with enema administration are not always fully appreciated.

    Observation:

    • A 2 1/2-year-old girl developed severe systemic toxicity after receiving two hypertonic phosphate enemas.
    • Clinical manifestations included coma, tetany, dehydration, hypotension, tachycardia, and hyperpyrexia.

    Findings:

    • Laboratory analysis revealed marked hyperphosphatemia, hypocalcemia, hypernatremia, and acidosis.
    • The observed clinical symptoms are consistent with severe electrolyte disturbances, particularly hypocalcemia secondary to hyperphosphatemia.
    • Calculations suggest significant absorption of both phosphorus and sodium from the enema solution.

    Implications:

    • This case underscores the potentially lethal complications of hypertonic phosphate enemas in children.
    • Healthcare providers must exercise caution and be aware of the risks associated with this seemingly routine procedure.
    • Alternative, safer methods for managing constipation in pediatric patients should be considered.

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