Chemical colitis due to glutaraldehyde: case series and review of the literature

Dig Dis Sci. 2009 Dec;54(12):2541-5. doi: 10.1007/s10620-008-0630-2.

Abstract

Chemical colitis can occur as a result of accidental contamination of endoscopes or by intentional/accidental administration of enemas containing various chemicals.We present three cases of glutaraldehyde induced colitis and review the cases in the literature. Glutaraldehyde induced colitis presents clinically with severe abdominal pain, bloody and mucoid diarrhea, rectal bleeding, and tenesmus 48-72 h after colonoscopy. Endoscopic findings are nonspecific and mimic ischemic colitis, inflammatory bowel disease, and infectious colitis. The timing of symptoms and the knowledge that glutaraldehyde is a chemical irritant to colonic mucosa is important for the diagnosis. The treatment is mainly supportive but sometimes necessitates mesalamine, prednisolone, or metronidazole and the resolution is rapid. In endoscopy units, strict adherence to published disinfection protocols is very important and the cleaning, rinsing and drying protocols also deserve the same attention.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / chemically induced
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Colitis / chemically induced*
  • Colitis / pathology
  • Colitis / therapy
  • Colonoscopes / adverse effects*
  • Colonoscopy / adverse effects*
  • Colonoscopy / instrumentation
  • Diarrhea / chemically induced
  • Disinfectants / adverse effects*
  • Equipment Contamination*
  • Female
  • Fluid Therapy
  • Gastrointestinal Agents / therapeutic use
  • Gastrointestinal Hemorrhage / chemically induced
  • Glutaral / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Time Factors

Substances

  • Anti-Inflammatory Agents
  • Disinfectants
  • Gastrointestinal Agents
  • Glutaral