Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T00:39:14.187Z Has data issue: false hasContentIssue false
  • English
  • Français

Bowel perforation after single-dose activated charcoal

Published online by Cambridge University Press:  21 May 2015

Jason P. Green  and
William McCauley
Jason P. Green
Affiliation:
Department of Emergency Medicine, University of Calgary, Calgary, Alta. At the time of writing, Dr. Green was at Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont
William McCauley*
Affiliation:
Department of Emergency Medicine, London Health Sciences Centre, and Division of Emergency Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont
*
Department of Emergency Medicine, London Health Sciences Centre, 375 South St., London ON N6A 4G5

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Patients presenting to the emergency department (ED) after medication overdose are often given activated charcoal initially for gastrointestinal decontamination. Complications of charcoal are rare, but do occur. The following case describes a patient with pre-existing undiagnosed diverticular disease who developed sigmoid perforation after a single dose of activated charcoal, given without cathartic for a drug overdose. A literature search revealed no other cases of bowel perforation associated with single-dose activated charcoal. This case report discusses adverse effects associated with activated charcoal and the role of cathartics in gastrointestinal decontamination.

Keywords

gastrointestinal decontaminationcharcoalsigmoid perforation
Type
Case Report • Observations de cas
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 5 , September 2006 , pp. 358 - 360
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

References

1.Bond, GR. The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state-of-the-art review. Ann Emerg Med 2002;39:273–86.Google Scholar
2.Goulbourne, KB, Cisek, JE. Small-bowel obstruction secondary to activated charcoal and adhesions. Ann Emerg Med 1994;24:108–10.Google Scholar
3.Watson, WA, Cremer, KF, Chapman, JA. Gastrointestinal obstruction associated with multiple-dose activated charcoal. J Emerg Med 1986;4:401–7.Google Scholar
4.Dorrington, CL, Johnson, DW, Brant, R. The frequency of complications associated with the use of multiple-dose activated charcoal. Ann Emerg Med 2003;41:370–7.CrossRefGoogle ScholarPubMed
5.Benson, B, VanAntwerq, M, Hergott, T. A fatality resulting from multiple dose activated charcoal therapy. Vet Hum Toxicol 1989;31:335.Google Scholar
6.Seger, D. Single-dose activated charcoal — backup and reassess. J Toxicol Clin Toxicol 2004;42:101–10.Google Scholar
7.Merriman, T, Stokes, K. Small bowel obstruction secondary to administrationof activated charcoal. Aust N Z J Surg 1995;65:288–9.Google Scholar
8.Atkinson, SW, Young, Y, Trotter, GA. Treatment with activated charcoal complicated by gastrointestinal obstruction requiring surgery. BMJ 1992;305:563.CrossRefGoogle ScholarPubMed
9.Ray, MJ, Padin, DR, Condie, JD, et al. Charcoal bezoar: small-bowel obstruction secondary to amitryptyline overdose therapy. Dig Dis Sci 1988;33:106–7.Google Scholar
10.Longdon, P, Henderson, A. Intestinal pseudo-obstruction following the use of enteral charcoal and sorbitol and mechanical ventilation with papaveretum sedation for theophylline poisoning. Drug Saf 1992;7:74–7.Google Scholar
11.Flores, F, Battle, WS. Intestinal obstruction secondary to activated charcoal. Contemp Surg 1987;30:57–9.Google Scholar
12.Anderson, IM, Ware, C. Drug points [letter]. BMJ 1987;294:578.Google Scholar
13.Gomez, HF, Brent, JA, Munoz, DC, et al. Charcoal stercolith with intestinal perforation in a patient treated for amitriptyline ingestion. J Emerg Med 1992;12:57–60.Google Scholar
14.Ross, JP, Small, TR, Lepage, PA. Imipramine overdose complicated by toxic megacolon. AmSurg 1998;64:242–4.Google Scholar
15.Mariani, PJ, Pook, N. Gastrointestinal tract perforation with charcoal peritoneum complicating orogastric intubation and lavage. Ann Emerg Med 1993;22:606–9.Google Scholar
16. American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. Single-dose activated charcoal [position statement]. Available at: http://www.clintox.org/Pos_Statements/Charcoal.html (accessed 2006 Aug 3).Google Scholar
17.Perry, H, Shannon, M. Emergency department gastrointestinal decontamination. Pediatr Ann 1996;25:19–26.Google Scholar
18.Position paper: cathartics [published erratum appears in J Toxicol Clin Toxicol 2004;42(7):1000]. J Toxicol Clin Toxicol 2004;42(3):243–53.Google Scholar