Intestinal pseudo-obstruction following the use of enteral charcoal and sorbitol and mechanical ventilation with papaveretum sedation for theophylline poisoning.

We report 2 cases of intestinal pseudo-obstruction, 1 fatal, which developed following the use of enteral activated charcoal with sorbitol, and mechanical ventilation with papaveretum ('Omnopon') sedation for the treatment of severe theophylline self-poisoning. While mechanical intestinal obstruction may rarely complicate the use of enteral activated charcoal, pseudo-obstruction has not been previously described. Causal mechanisms and prophylaxis are discussed, highlighting a possible interaction between theophylline and papaveretum, and the dangers of multidose enteral charcoal with sorbitol in this context.