title: [Water intoxication following preparation for barium enema].
abstract: BACKGROUND
  Induction of water intoxication from tap water enemas was reported a few years ago. Its treatment is still debated.
  
  
  METHODS
  A 4 1/2 year-old boy was admitted because he suffered from coma grade I. A barium enema had been prescribed for fecal incontinence and the patient had been given orally about 4 liters of water during the 24 hours preceding this investigation. Blood examination showed;: Na 122 mEq/l; K 3 mEq/l; Cl 87 mEq/l. Brain CT scan was normal. The patient was placed under restriction of fluid and was given i.v. 5.8% NaCl solution (2 mM/kg) for 3 hours. Convulsions appeared despite this treatment requiring intubation and ventilation plus increasing doses of NaCl: 20% solution (2 mM/kg) for 30 minutes followed by 2 mM/kg for 3 hours, associated with mannitol and furosemide infusion.
  
  
  CONCLUSIONS
  Use of hypertonic saline solutions in the treatment of water intoxication is discussed. Acute hyponatremia must be rapidly corrected using hypertonic saline solution plus restriction of fluid and diuretic.
authors.affiliation: Service de pédiatrie et de médecine néonatale, CHI de Poissy, France.
authors.forename: P
authors.initials: P
authors.lastname: Blanc
authors.forename: R
authors.initials: R
authors.lastname: Carbajal
authors.forename: A
authors.initials: A
authors.lastname: Paupe
authors.forename: R
authors.initials: R
authors.lastname: Lenclen
authors.forename: S
authors.initials: S
authors.lastname: Couderc
authors.forename: M
authors.initials: M
authors.lastname: Olivier-Martin
mesh_terms: D001466:Barium Sulfate; D002675:Child, Preschool; D004733:Enema / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D014869:Water Intoxication / Q000188:drug therapy / Q000209:etiology*
chemical_list: D012462:Saline Solution, Hypertonic; D001466:Barium Sulfate
vernacular_title: Intoxication par l'eau après une préparation pour un lavement baryté.