Background: Hypertonic sodium phosphate enema (Fleet) are available for relief of constipation. They may be responsible for life-threatening electrolyte disturbances (hyperphosphatemia, 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.
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