Intestinal pseudo-obstruction following the use of enteral charcoal and sorbitol and mechanical ventilation with papaveretum sedation for theophylline poisoning.
We report 2 cases of intestinal pseudo-obstruction, 1 fatal, which developed following the use of enteral activated charcoal with sorbitol, and mechanical ventilation with papaveretum ('Omnopon') sedation for the treatment of severe theophylline self-poisoning. While mechanical intestinal obstruction may rarely complicate the use of enteral activated charcoal, pseudo-obstruction has not been previously described. Causal mechanisms and prophylaxis are discussed, highlighting a possible interaction between theophylline and papaveretum, and the dangers of multidose enteral charcoal with sorbitol in this context.
Longdon
P
P
Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Henderson
A
A
D000328:Adult; D002606:Charcoal / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D004750:Enteral Nutrition; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009892:Opium / Q000627:therapeutic use*; D013012:Sorbitol / Q000009:adverse effects* / Q000627:therapeutic use; D013806:Theophylline / Q000506:poisoning*; D012122:Ventilators, Mechanical
D002606:Charcoal; D013012:Sorbitol; D009892:Opium; D013806:Theophylline