USE OF WHOLE BOWEL IRRIGATION IN AN INFANT FOLLOWING IRON OVERDOSE

被引：15

作者：

EVERSON, GW

BERTACCINI, EJ

OLEARY, J

机构：

[1] Regional Poison Center, Santa Clara Valley Medical Center, San Jose, CA

[2] Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA

来源：

AMERICAN JOURNAL OF EMERGENCY MEDICINE | 1991年 / 9卷 / 04期

关键词：

IRON; POISONING; CHILDREN; IRRIGATION;

D O I：

10.1016/0735-6757(91)90060-W

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

An 11-month-old, 11-kg infant presented to the emergency department after ingesting 130 to 150 mg/kg of elemental iron. Emesis was induced twice and the child was lavaged throughout a 4-hour period with some tablet return. An abdominal radiograph after gastrointestinal decontamination showed at least 16 whole iron tablets remaining in the stomach. Serum iron drawn 2 hours postingestion was 46.7 μmol/L. Blood glucose was 7.7 mmol/L and white blood count was 21,800 mm3. Despite a second lavage 8 hours postingestion, a large number of whole tablets were visualized in the stomach per radiograph. Whole bowel irrigation with polyethylene glycol electrolyte lavage solution (Golytely, Braintree Laboratories, Inc, Braintree, MA) was begun via nasogastric tube 14 hours after the ingestion. Serial abdominal radiographs showed tablet movement out of the stomach within 4 hours after initiating whole bowel irrigation. This case demonstrates the safety and efficacy of WBI in an infant when conventional gastrointestinal decontamination has failed. © 1991.

引用

页码：366 / 369

页数：4

共 10 条

[1]

Kulig, Bar-or, Cantrill, Et al., Management of acutely poisoned patients without gastric emptying, Ann Emerg Med, 14, pp. 562-567, (1985)

[2]

Tenenbein, Inefficacy of gastric emptying procedures, J Emerg Med, 3, pp. 133-136, (1985)

[3]

Vale, Meredith, Proudfoot, Syrup of ipecacuanha: Is it really useful?, Br Med J, 293, pp. 1321-1322, (1986)

[4]

Albertson, Derlet, Foulke, Et al., Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions, Ann Emerg Med, 18, pp. 56-59, (1989)

[5]

Peterson, Fifield, Emergency gastrotomy for acute iron poisoning, Ann Emerg Med, 9, pp. 262-264, (1980)

[6]

Tenenbein, Whole bowel irrigation in iron poisoning, J Pediatr, 111, pp. 142-145, (1987)

[7]

Tenenbein, Whole bowel irrigation as a gastrointestinal decontamination procedure after acute poisoning, Med Toxicol, 3, pp. 77-84, (1988)

[8]

Tenenbein, Cohen, Sitar, Whole bowel irrigation as a decontamination procedure after acute drug overdose, Arch Intern Med, 147, pp. 905-907, (1987)

[9]

Tuggle, Hoelzer, Tunell, Et al., The safety and cost effectiveness of polyethylene glycol electrolyte solution bowel preparation in infants and children, J Pediatr Surg, 22, pp. 513-515, (1987)

[10]

Millar, Rode, Buchler, Et al., Whole gut lavage in children using an iso-osmolar solution containing polyethylene glycol (Golytely), J Pediatr Surg, 23, pp. 822-824, (1988)

← 1 →