A Case of Upper Airway and Esophageal Injury after Ingestion of Sodium Picosulfate and Magnesium Citrate for Colonoscopy

ABSTRACT

Sodium picosulfate and magnesium citrate are widely used low volume bowel cleansing agents considered to be effective and relatively safe. We describe a case of a woman who presented with an upper airway and esophageal injury after ingestion of a sodium picofulfate and magnesium citrate. A 63-year-old woman presented to emergency department complaining of throat pain and hoarseness after ingestion of sodium picosulfate and magnesium citrate as preparation for colonoscopy. This powder is dissolved in a low volume of water. She had ingested the substance that was not completely dissolved. After ingestion, she experienced a burning sensation in the throat. Promptly, neck radiography and computed tomography (CT) were performed. Radiography revealed epiglottis swelling and narrowing airway. Computed tomography demonstrated diffuse soft tissue edema and thickening with increased enhancement in the upper airway and entire esophagus. She was admitted and treated with parenteral nutrition, intravenous proton pump inhibitor, empirical antibiotics, and steroids. Nine days after the admission, she underwent an esophagogastroduodenoscopy (EGD). Esophageal multiple ulcerative lesions with exudate were observed. Twelve days after admission, she was discharged from the hospital with improvement of pain in her throat and toleration to a solid diet.