Chemical Colitis Due to Glutaraldehyde: Case Series and Review of the Literature

• Published in: Digestive diseases and sciences Vol. 54; no. 12; pp. 2541 - 2545
• Main Authors: Ahishali, Emel, Uygur-Bayramiçli, Oya, Dolapçioğlu, Can, Dabak, Reşat, Mengi, Alperen, Işik, Aygün, Ermiş, Elvan
• Format: Journal Article
• Language: English
• Published: Boston Boston : Springer US 01-12-2009; Springer US; Springer Nature B.V
• Subjects: Abdominal Pain - chemically induced; Aged; Anti-Inflammatory Agents - therapeutic use; Biochemistry; 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; Gastroenterology; Gastrointestinal Agents - therapeutic use; Gastrointestinal Hemorrhage - chemically induced; Glutaral - adverse effects; Hepatology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Review; Time Factors; Transplant Surgery; Chemical colitis; Glutaraldehyde; Endoscopy
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-008-0630-2

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.