Symptoms: Gastrointestinal discomfort, diarrhoea and vomiting. Large doses of iron salts may have irritant and corrosive effects on the mucosa, and necrosis and perforation may occur; stricture formation may subsequently follow. Symptoms which may not appear for several hours include epigastric pain, diarrhoea, vomiting and haematemesis. Circulatory failure may follow if the diarrhea and haemorrhage are severe. Hours or days later after apparent recovery, metabolic acidosis, convulsions and coma may occur. If the patient survives, symptoms of acute liver necrosis may develop and may lead to death due to hepatic coma.
Treatment: In acute poisoning, use the desferrioxamine procedure. If desferrioxamine is not available, empty the stomach immediately by emesis and lavage using a solution of sodium bicarbonate and leave some of the solution in the stomach. Fluid loss should be replaced by the IV administration of the compound sodium lactate injection or sodium chloride and dextrose injection. Exchange transfusions may be necessary in severe cases. In treating iron poisoning, speed is essential to block absorption of iron from the gastrointestinal tract.