Park GW, Park N, Kuk JC, Shin EJ, Lim DR. Anaphylactic shock induced by polyethylene glycol after bowel preparation for the colorectal cancer surgery: A case report. World J Clin Cases 2023; 11(23): 5589-5594 [PMID: 37637691 DOI: 10.12998/wjcc.v11.i23.5589]
Corresponding Author of This Article
Dae Ro Lim, MD, PhD, Surgeon, Department of General Surgery, Soonchunhyang Bucheon Hospital, Jomaru-ro 170, Bucheon 14584, South Korea. limdaero@schmc.ac.kr
Research Domain of This Article
Allergy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2023; 11(23): 5589-5594 Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5589
Anaphylactic shock induced by polyethylene glycol after bowel preparation for the colorectal cancer surgery: A case report
Go Woon Park, Nahyeon Park, Jung Cheol Kuk, Eung Jin Shin, Dae Ro Lim
Go Woon Park, Nahyeon Park, Jung Cheol Kuk, Eung Jin Shin, Dae Ro Lim, Department of General Surgery, Soonchunhyang Bucheon Hospital, Bucheon 14584, South Korea
Author contributions: Park GW contributed to writing the paper, editing and data collection; Park GW, Park N, and Kuk JC contributed to data collection; Shin EJ contributed to supervision and reviewing the paper; Lim DR contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
Informed consent statement: The patient has given written informed consent for the publication of this case.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dae Ro Lim, MD, PhD, Surgeon, Department of General Surgery, Soonchunhyang Bucheon Hospital, Jomaru-ro 170, Bucheon 14584, South Korea. limdaero@schmc.ac.kr
Received: May 16, 2023 Peer-review started: May 16, 2023 First decision: June 13, 2023 Revised: June 27, 2023 Accepted: July 25, 2023 Article in press: July 25, 2023 Published online: August 16, 2023 Processing time: 92 Days and 2.7 Hours
Abstract
BACKGROUND
Polyethylene glycol (PEG) is widely used as an additive because of its hydrophilic and chemically inert properties. However, there are been increasing reports of PEG allergies, including anaphylaxis, although they are still rare. This case report aims to raise awareness, that the commonly used bowel cleansing agent containing PEG can cause serious allergic reactions.
CASE SUMMARY
Prior to surgery for sigmoid colon cancer, a 63-year-old man was prescribed a bowel cleansing agent containing PEG. Within 30 min of ingestion, he developed symptoms of anaphylactic shock and did not respond to initial intramuscular epinephrine injection. Under diagnosis of anaphylaxis to PEG, he was stabilized with fluid hydration and continuous norepinephrine infusion.
CONCLUSION
While allergic reactions to PEG are rare, they can be life-threatening. Therefore, it is crucial for clinicians to be aware of this possibility and to diagnose and resuscitate patients immediately.
Core Tip: Polyethylene glycol (PEG) is a widely used additive and generally considered a non-allergenic substance due to its chemical inertness and poor absorption in the gastrointestinal tract. Due to its hydrophilic nature, it is also used as bowel cleansing agents before colonoscopy and colorectal surgery. Although allergic reactions to PEG are rare, reports of such allergies are increasing and can be life-threatening anaphylactic shock. By presenting a 63-year-old man who experienced anaphylactic shock during bowel preparation using PEG, we announced the allergic potential of PEG for timely diagnosis and proper management.
