Acute Iron Intoxication with Intestinal Infarction Managed in Part by Small Bowel Resection

This report deals with a case of acute iron intoxication in a child in which acute and chronic gastrointestinal abnormalities developed as a consequence of severe intestinal infarction and corrosion. Microscopic examination of resected small bowel revealed prominent iron deposits in areas of necrosis, in basement membranes of lymphatics, capillaries, and venules, and within platelet-fibrin thrombi. The clinical history and microscopic findings are consistent with the hypothesis of a direct action of absorbed iron on vascular walls as the pathophysiologic mechanism for the toxic effects of iron on the gastrointestinal tract. Acute and long-term management of iron intoxication is discussed in the context of the observations in this case.