Esophagogastroduodenoscopy for Suspected Gastrointestinal Deposits

The recent article by Young et al¹ suggests that colonoscopy and esophagogastroduodenoscopy should be performed early in the setting of suspected continued absorption from a gastrointestinal deposit. In justifying this, the authors describe a patient who swallowed a small plastic bag containing phencyclidine. After undergoing gastric lavage and activated charcoal administration the patient received 11 L of a polyethylene glycol electrolyte lavage solution (PEG-ELS) between days 11 and 14 (average of 150 mL/h) without packet passage. The plastic bag was eventually passed on hospital day 20. Because of this delay in passage, the authors conclude that esophagogastroduodenoscopy should be performed early to avoid potential complications. However, had the PEG-ELS been employed in proper whole-bowel irrigation (WBI) doses (2000 mL/h for an adult) instead of the cathartic doses (150 mL/h), this delay in packet passage might not have occurred.

Correctly performed, WBI has been safely and effectively used as a