[Water intoxication following preparation for barium enema].

Abstract

BACKGROUND:

Induction of water intoxication from tap water enemas was reported a few years ago. Its treatment is still debated.

CASE REPORT:

A 4 1/2 year-old boy was admitted because he suffered from coma grade I. A barium enema had been prescribed for fecal incontinence and the patient had been given orally about 4 liters of water during the 24 hours preceding this investigation. Blood examination showed;: Na 122 mEq/l; K 3 mEq/l; Cl 87 mEq/l. Brain CT scan was normal. The patient was placed under restriction of fluid and was given i.v. 5.8% NaCl solution (2 mM/kg) for 3 hours. Convulsions appeared despite this treatment requiring intubation and ventilation plus increasing doses of NaCl: 20% solution (2 mM/kg) for 30 minutes followed by 2 mM/kg for 3 hours, associated with mannitol and furosemide infusion.

CONCLUSION:

Use of hypertonic saline solutions in the treatment of water intoxication is discussed. Acute hyponatremia must be rapidly corrected using hypertonic saline solution plus restriction of fluid and diuretic.

• Authors: P Blanc, R Carbajal, A Paupe, R Lenclen, S Couderc, M Olivier-Martin
• Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie (Arch Pediatr) Vol. 2 Issue 9 Pg. 871-3 (Sep 1995) ISSN: 0929-693X [Print] France
• Vernacular Title: Intoxication par l'eau après une préparation pour un lavement baryté.
• PMID: 7581785 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Saline Solution, Hypertonic
• Barium Sulfate

Topics

• Barium Sulfate
• Child, Preschool
• Enema (adverse effects)
• Humans
• Male
• Saline Solution, Hypertonic (therapeutic use)
• Water Intoxication (drug therapy, etiology)