The paucity of recorded perforations of the extraperitoneal portion of the rectum during the course of an enema seems warrant enough for an additional case report.
A 70-year-old man stated that he had received an enema of the disposable bag type * five days previously. The insertion of the enema tip was associated with sudden, severe, rectal pain followed by tenesmus, urgency to defecate, and a feeling of faintness. He passed bright red blood per rectum. Pain in the rectal region persisted and became gradually worse over the next five days. When first seen he was markedly weakened, with additional symptoms of loss of defecatory sense and incontinence of stool while standing to urinate. He denied any bowel abnormalities prior to the enema other than occasional bright red blood spots on the toilet tissue.
Examination revealed an acutely ill, debilitated man. The abdomen was soft and nontender, without palpable masses. Bowel
BLATT LJ. Injury of the Rectum by Tip of Disposable EnemaReport of a Case. AMA Arch Surg. 1960;80(3):442–444. doi:10.1001/archsurg.1960.01290200086014
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