Document Detail


Chemical colitis.
MedLine Citation:
PMID:  18209577     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chemical colitis can occur as a result of accidental contamination of endoscopes or by intentional or accidental administration of enemas containing various chemicals. Most cases have occurred after accidental contamination of endoscopes with glutaraldehyde and/or hydrogen peroxide. There have been multiple case reports of chemical colitis resulting from unintentional administration of caustic chemicals. Intentional administration of corrosive enemas has been implicated in sexual practices, bowel cleansing, or in suicide attempts. Patients present with nonspecific symptoms including abdominal pain, rectal bleeding, and/or diarrhea. As chemical colitis remains rare, the literature consists of scattered case reports and small series. Agents implicated in chemical colitis that are covered in this review include alcohol, radiocontrast agents, glutaraldehyde, formalin, ergotamine, hydrofluoric acid, sulfuric acid, acetic acid, ammonia, soap, sodium hydroxide, hydrogen peroxide, herbal medicines, chloro-m-xylenol, and potassium permanganate. Clinical, endoscopic, and histologic features are outlined for each agent in addition to the existing literature. Given the nonspecific presentation of many cases of chemically induced colitis, the diagnosis can be challenging if the pertinent history is not obtained. Most patients demonstrate the resolution of chemical-induced colitis after conservative or medical therapy. Depending on the depth and extent of injury, patients rarely require colectomy for ischemic colitis and/or peritonitis. Other postingestion complications include colonic strictures and rectovaginal fistulae. The benefits of medical therapy compared with conservative therapy are not known, as comparative clinical management trials have not been performed.
Authors:
Sarah Sheibani; Lauren B Gerson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  42     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-22     Completed Date:  2008-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-21     Citation Subset:  IM    
Affiliation:
Division of Medicine, Stanford University School of Medicine, Stanford, CA 94305-5202, USA.
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MeSH Terms
Descriptor/Qualifier:
Acetic Acid / poisoning
Administration, Rectal
Animals
Anti-Infective Agents, Local / administration & dosage,  adverse effects*
Caustics / poisoning
Colitis / chemically induced*,  diagnosis,  therapy
Colonoscopy
Contrast Media / adverse effects*
Disinfectants / administration & dosage,  adverse effects*
Enema / adverse effects*
Ergotamine / administration & dosage,  adverse effects
Ethanol / poisoning
Formaldehyde / poisoning
Glutaral / administration & dosage,  adverse effects*
Humans
Hydrofluoric Acid / poisoning
Sulfuric Acids / poisoning
Vasoconstrictor Agents / administration & dosage,  adverse effects
Chemical
Reg. No./Substance:
0/Anti-Infective Agents, Local; 0/Caustics; 0/Contrast Media; 0/Disinfectants; 0/Sulfuric Acids; 0/Vasoconstrictor Agents; 111-30-8/Glutaral; 113-15-5/Ergotamine; 50-00-0/Formaldehyde; 64-17-5/Ethanol; 64-19-7/Acetic Acid; 7664-39-3/Hydrofluoric Acid; 7664-93-9/sulfuric acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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