Enema-induced severe hyperphosphatemia in children

Biebl, Ariane; Grillenberger, Andrea; Schmitt, Klaus

doi:10.1007/s00431-008-0705-2

Cited by 31 publications

(11 citation statements)

References 5 publications

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“…Phosphate enemas are used for the treatment of acute and chronic constipation and for colon cleaning in both children and adults. It increases motility by creating osmotic activity and distension in the rectum (8)(9)(10)(11). For this reason, there is no risk of perforation which occurs i n pneumatic reduction or hydrostatic method that is caused by intraluminal pressure increase.…”

Section: Discussionmentioning

confidence: 99%

The Use of Phosphate Enama in the Treatment of Short Segment Intususception Cases

Bilici¹,

Avcı²

2019

Eastern J Med

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Section: Discussionmentioning

confidence: 99%

The Use of Phosphate Enama in the Treatment of Short Segment Intususception Cases

Bilici¹,

Avcı²

2019

Eastern J Med

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“…The first step of the treatment of hyperphosphemia secondary to phosphate enemas is to remove phosphorus from the intestinal lumen (eg with water enemas) 13 , a good renal function should be ensured to determine the next steps. With adequate renal function, hyperhydration and diuresis (phosphorus removal is mainly renal) should be performed 5,6 .…”

Section: Discussionmentioning

confidence: 99%

Tetania severa por uso de enemas fosfatados, reporte de caso

Sánchez¹,

Swaneck

Díaz

2017

Rev. chil. pediatr.

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Background: Phosphate enemas are frequently used in the treatment of constipation. Errors in dosage and administration can lead to severe complications. Objective: To report a case of severe toxicity of phosphate enemas in a child with no risk factors. Case: 2 years old female, with functional constipation, was brought to emergency department because abdominal pain. She was diagnosed with fecal impaction and received half a bottle of Fleet Adult® (Laboratorio Synthon, Chile) two times, with no clinical resolution, deciding to start proctoclisis in pediatric ward. Soon after admission, she presented painful tetany, but alert and oriented. Patient was transferred to PICU where severe hyperphosphatemia and secondary hypocalcemia were confirmed. Her treatment included electrolyte correction; removal of residual phosphate enema and hyperhydration. Tetany resolved over 2 hours after admission and no other complications. Proctoclisis was performed and patient was discharged three days after admission with pharmacological management of constipation. Conclusion: Phosphate enemas may cause serious complications in children with no risk factors. Errors in dosage, administration and removal of the enema are causes of toxicity in this group. Pediatricians and health personnel must be aware of risks and signs of toxicity of phosphate enema.

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“…This occurs more frequently among patients with neuromuscular and intestinal disorders characterized by constipation, dysmotility, retention, and absorption of applied enema [1,2]. The use of enema in newborns and infants is rarely seen due to an intense variability in the evacuation pattern of children in this age group [3].…”

Section: Introductionmentioning

confidence: 99%

Flow-through peritoneal dialysis in neonatal enema-induced hyperphosphatemia

Kostić

Rodrigues²,

Leal³

et al. 2010

Pediatr Nephrol

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Fleet enemas are hypertonic solutions with an osmotic action and a high concentration of phosphate. When retained in the human body they have a great toxic potential, causing severe hydro-electrolyte disorders in children, especially in newborns. We report the case of a previously healthy 8-day-old newborn who needed neonatal intensive care treatment after the inadvertent administration of an osmotically active hypertonic phosphate enema. Taking into account that phosphate removal by peritoneal dialysis (PD) strongly depends on total dialysate turnover, we chose continuous flow PD (CFPD) as the treatment option, with a successful outcome. Clinical experience with this dialytic modality is limited to a few case reports in pediatric and adult patients. To the best of our knowledge, we report here the first description of CFPD in the setting of acute phosphate nephropathy in the neonatal period. The modality of PD described here has potential as an alternative management option as it is a highly efficient, methodologically simple, and low-cost method without any need for sophisticated equipment. Physicians and parents should be aware of the adverse effects of a hypertonic phosphate enema and should never use these medications in infants and newborns.

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Enema-induced severe hyperphosphatemia in children

Cited by 31 publications

References 5 publications

The Use of Phosphate Enama in the Treatment of Short Segment Intususception Cases

The Use of Phosphate Enama in the Treatment of Short Segment Intususception Cases

Tetania severa por uso de enemas fosfatados, reporte de caso

Flow-through peritoneal dialysis in neonatal enema-induced hyperphosphatemia

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