Retrograde hydrostatic irrigation enema-induced perforation of the sigmoid colon in a chronic renal failure patient before colonoscopy.

Abstract

We present a rare case of colon perforation caused by hydrostatic irrigation enema in a patient with chronic renal failure. A 76-year-old woman was admitted to our hospital because of an exacerbation of lumbar pain and increased difficulty in walking. She had a medical history of traumatic neck pain and chronic lower back pain, which had been treated with non-steroidal anti-inflammatory drugs (NSAIDs) for 8 years. On admission, the C-reactive protein level was 6.8 mg/dl, so we planned to do a colonoscopy to determine the cause of inflammation. The patient developed abdominal pain approximately 3.5 h after a pre-procedural enema was administered. An emergency operation was performed and a small perforation was found in the sigmoid colon. We conclude that the cause of the colon perforation was a combination of the use of a hydrostatic retrograde irrigation enema in a patient with chronic renal failure who had been treated with long-term NSAIDs.

• Authors: H Nakamura, M Iyoda, K Sato, K Kitazawa
• Journal: The Journal of international medical research (J Int Med Res) 2005 Nov-Dec Vol. 33 Issue 6 Pg. 707-10 ISSN: 0300-0605 [Print] England
• PMID: 16372590 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Colon, Sigmoid (injuries)
• Colonoscopy (methods)
• Enema (adverse effects)
• Female
• Humans
• Inflammation (diagnosis, drug therapy)
• Kidney Failure, Chronic
• Peritonitis (diagnosis, etiology, surgery)
• Tomography Scanners, X-Ray Computed