WATER-INTOXICATION FOLLOWING BARIUM ENEMA

Background. - Reduction of water intoxication from tapwater enemas was reported a few years ago. Its treatment is still debated. Case report . - A 4 1/2 year-old boy was admitted because he suffered from coma gr ade L A barium enema had been prescribed for fecal incontinence and th e patient had been given orally about 4 liters of water during the 24 hours preceding this investigation. Blood examination showed: Na 122 m Eq/l; K 3 mEq/l; CE 87 mEq/l. Brain CT scan was normal. The patient wa s placed under restriction of fluid and was given iv 5.8% NaCl solutio n (2 mM/kg) for 3 hours. Conclusions appeared despite this treatment r equiring intubation and ventilation plus increasing doses of NaCl: 20% solution (2 mM/kg) for 30 minutes followed by 2 mM/kg for 3 hours, as sociated with mannitol and furosemide infusion. Conclusion. - Use of h ypertonic saline solutions in the treatment of water intoxication is d iscussed. Acute hyponatremia must be rapidly corrected using hypertoni c saline solution plus restriction of fluid and diuretic.