Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Mar 27;18(1):176-180.
doi: 10.1159/000538158. eCollection 2024 Jan-Dec.

A Case Report of Pulmonary Edema Secondary to Large Volume Bowel Preparation in a High-Risk Patient with Multiple Cardiopulmonary Co-Morbidities

Kush Fansiwala  1 , Preeti Prakash  2 , Christopher L Coe  1 , Guy A Weiss  3
Affiliations
Case Reports

A Case Report of Pulmonary Edema Secondary to Large Volume Bowel Preparation in a High-Risk Patient with Multiple Cardiopulmonary Co-Morbidities

Kush Fansiwala et al. Case Rep Gastroenterol. .

Abstract

Introduction: Polyethylene glycol 3,350 and electrolytes is a commonly prescribed bowel regimen for colonoscopy preparation with an overall excellent safety profile, though prior reports have demonstrated risk of volume overload.

Case presentation: A 55-year-old man with significant cardiopulmonary co-morbidities was admitted for acute hypoxic respiratory failure and subsequent evaluation for lung transplant. As part of his pretransplant evaluation, colon cancer screening was advised. Despite multiple days of bowel preparation, his stools contained sediment. Unfortunately, he developed pulmonary edema due to prolonged bowel preparation.

Conclusion: While bowel preparation is considered generally safe, our case report highlights the importance of judicious use with monitoring in high-risk individuals.

Keywords: Colonoscopy; Complication; Pulmonary edema; Screening colonoscopy.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

References

    1. Enestvedt BK, Tofani C, Laine LA, Tierney A, Fennerty MB. 4-Liter split-dose polyethylene glycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2012;10(11):1225–31. - PubMed
    1. Wexner SD, Beck DE, Baron TH, Fanelli RD, Hyman N, Shen B, et al. A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointest Endosc. 2006;63(7):894–909. - PubMed
    1. Paap CM, Ehrlich R. Acute pulmonary edema after polyethylene glycol intestinal lavage in a child. Ann Pharmacother. 1993;27(9):1044–7. - PubMed
    1. Granberry MC, White LM, Gardner SF. Exacerbation of congestive heart failure after administration of polyethylene glycol–electrolyte lavage solution. Ann Pharmacother. 1995;29(12):1232–5. - PubMed
    1. Argent A, Hatherill M, Reynolds L, Purves L. Fulminant pulmonary oedema after administration of a balanced electrolyte polyethylene glycol solution. Arch Dis Child. 2002;86(3):209. - PMC - PubMed

Publication types