Anaphylactic shock induced by polyethylene glycol after bowel preparation for the colorectal cancer surgery: A case report

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.

Keywords: Polyethylene glycol; Anaphylaxis; Sigmoid colon cancer; Bowel preparation; Case report

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.