Severe phosphate enema poisoning in an infant.

Background, - Hypertonic sodium phosphate enema (Fleet) are available for relief of constipation. They may be responsible for life-threatening electrolyte disturbances (hyperphosphatemio, hypernatremia, hypocalcemia) and severe dehydration. Observation, - A 14-month-old child with a neonatal repaired Hirschsprung's disease was urgently admitted for apathy. The clinical diagnosis was sepsis from intestinal origin. A few hours before admission, the child had received a pediatric phosphate enema ("Fleet Enema"). The clinical symptoms and the observed electrolyte disturbances were the consequences of the intoxication by the enema. Conclusion, - In children with renal insufficiency or bowel dysfunction, phosphate enemas are dangerous. Even in normal children, they should not be used under 2 years of age and only with extreme caution between 2 and 5 years. (C) 1998 Elsevier, Paris.