SUICIDE ATTEMPT BY MEANS OF ASPIRIN ENEMA

OBJECTIVE: To report a suicide attempt with an aspirin enema. CASE SUM MARY: A patient presented to the emergency room after self-administeri ng, in enema form, approximately 700 aspirin tablets dissolved in wate r. Over the next 12 hours the patient became progressively acidemic wi th eventual cardiac arrest and subsequent chronic hypoxic encephalopat hy. DISCUSSION: This patient's poor outcome was the result of retained aspirin products in the rectal vault combined with the failure to rec ognize the delayed absorption properties of rectally administered aspi rin. CONCLUSIONS: In rectal aspirin overdoses, aspirin absorption from the rectum may occur over a long period of time. It is important to r emove as much aspirin from the rectum as possible and to closely monit or these patients so that appropriate therapy may be started quickly. Activated charcoal given both in enema and oral form may help decrease aspirin absorption. Hemodialysis should be available and performed wi thout delay should the patient require it.