Everson G W, Bertaccini E J, O'Leary J
Regional Poison Center, Santa Clara Valley Medical Center, San Jose, CA 95128.
Am J Emerg Med. 1991 Jul;9(4):366-9. doi: 10.1016/0735-6757(91)90060-w.
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 mumol/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.
一名11个月大、体重11公斤的婴儿在摄入130至150毫克/公斤元素铁后被送往急诊科。催吐进行了两次，在4小时内对患儿进行洗胃，有一些药片回流。胃肠道去污后腹部X光片显示胃内至少残留16片完整的铁片。摄入后2小时测得的血清铁为46.7微摩尔/升。血糖为7.7毫摩尔/升，白细胞计数为21,800立方毫米。尽管在摄入后8小时进行了第二次洗胃，但每次X光片显示胃内仍有大量完整药片。摄入14小时后通过鼻胃管开始用聚乙二醇电解质灌洗液（GoLYTELY，Braintree Laboratories公司，马萨诸塞州布伦特里）进行全肠道灌洗。连续的腹部X光片显示在开始全肠道灌洗后4小时内药片移出了胃。该病例证明了在传统胃肠道去污失败时，全肠道灌洗对婴儿的安全性和有效性。
