J Korean Surg Soc.  2011 Nov;81(5):350-354. 10.4174/jkss.2011.81.5.350.

Intractable rectal stricture caused by hot water enema

• Kye BH
• Kim HJ
• Lee KM
• Cho HM

• KMID: 2096690
• DOI: http://doi.org/10.4174/jkss.2011.81.5.350

Abstract

Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema.

Keyword

Hot water enema; Rectal burn; Rectal stricture; Constipation

MeSH Terms

Burns
Constipation
Constriction, Pathologic
Enema
Female
Humans
Middle Aged
Stents
Water
Water

Reference

1. Diarra B, Roudie J, Ehua Somian F, Coulibaly A. Caustic burns of rectum and colon in emergencies. Am J Surg. 2004. 187:785–789.

2. Sashiyama H, Hamahata Y, Matsuo K, Akagi K, Tsutsumi O, Nakajima Y, et al. Rectal burn caused by hot-water coffee enema. Gastrointest Endosc. 2008. 68:1008.

3. Jones LE, Norris WE. Rectal burn induced by hot coffee enema. Endoscopy. 2010. 42:2. E26.

4. Ridge JA, Way LW. Sleisenger MH, Fordtran JS, editors. Abdominal pain in gastrointestinal disease. Gastrointestinal disease: pathophysiology, diagnosis, management. 1993. 5th ed. Philadelphia: Saunders;150–161.

5. Schouten WR, Gordon PH. Gordon PH, Nivatvongs S, editors. Constipation. Principles and practice of surgery for the colon, rectum, and anus. 2007. 3rd ed. New York: Informa Healthcare;1081–1123.

6. Sternberg A, Iuchtman M, Auslander L, Sternberg E, Robinson S, Fireman Z. Acute proctitis after a hot-water enema. J Clin Gastroenterol. 1995. 20:80–82.

7. Schlegel RD, Dehni N, Parc R, Caplin S, Tiret E. Results of reoperations in colorectal anastomotic strictures. Dis Colon Rectum. 2001. 44:1464–1468.

8. Johansson C. Endoscopic dilation of rectal strictures: a prospective study of 18 cases. Dis Colon Rectum. 1996. 39:423–428.

9. Garcea G, Sutton CD, Lloyd TD, Jameson J, Scott A, Kelly MJ. Management of benign rectal strictures: a review of present therapeutic procedures. Dis Colon Rectum. 2003. 46:1451–1460.