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Question :

Posted On : 01 Mar 2007

Sir, I am giving a personal experience of having a case of hyponatremia induced by a phosphate enema.
7 year old girl was given 75 ml of phosphate enema for evacuating the hard impacted stools. Within 5 minutes she started to vomit and became very lethargic. Sodium was 122 and potassium 2.9. She was managed with 500ml of Normal Saline given over 1hr, ORS by mouth. After the infusion, sodium was 132 and K plus 3.4 and she was symptomatically much better. My querries are 1} Is this complication following phosphate enema common? 2} Was the dose used too high {75 ml ,weight was 25.7 kg}? 3}Was the management right? 4} What is the most safe and effective enema in children?

Expert Answer :

No expert answer available.

Answer Discussion :

chzafari2003

i think that this is a rare complication and dose was alright

18 years ago

JAIME BIMSTEIN

IS NOT COMMON BUT EXPECTED TO HAPPEN. THE DOSE CAN BE AS MUCH AS 10ML-KG

18 years ago

sn joshi

dose of enema is high

18 years ago

DR EASH HOSKOTE

The most common complication would be dyselectrolytemia,particularty hyponatremia.Usually enema is avoided in children.Ideally, laxatives are much better and safer, particularly bulk laxatives. Enemas NO- NO.

18 years ago

pediatriconcall

Hyponatermia is a known complication in phosphate enema.
Sodium biphosphate and sodium phosphate is available as an enema specifically for use by children ages 2 to 11 years. The dose is usually half the adult dose {about 60 ml}. Hyponatremia should not be corrected very rapidly unless the child has convulsions. The aimed serum sodium level should be an increase in 10Meq-L in 24 hours. Thus with a serum sodium of 122, you must target to achieve a level of 132-135 in next 25 hours {a rise of 0.5meq in half an hour}. Apart from enema, one can use glycerine suppository or milk of magnesia as laxative in children.

18 years ago

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