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May 1966

Rectal Perforation With Profuse Bleeding Following an Enema: Case Report and Review of the Literature

Author Affiliations

From the Department of Surgery, Duke University Medical Center, Durham.

Arch Surg. 1966;92(5):715-717. doi:10.1001/archsurg.1966.01320230063011

ALTHOUGH it is impossible to estimate the numbar of enemas administered each year, one would suspect that it is a significant and growing number. The vast majority of enemas produce their desired effect without any accompanying complications. However, laceration and rupture of the rectum have been reported following the administration of enemas.1-7 Occasionally, rectal bleeding is associated with trauma, but it rarely is profuse and rarely occurs as the presenting sign of laceration or rupture.

Large and Mukheiber reported a case of laceration of the rectum following enema administration and reviewed 30 other cases that had been reported in the English literature.1 In none of these cases was there excessive bleeding. Turell, in reviewing his experience with rectal perforations following an enema, reported only two cases where surgical intervention was necessary because of bleeding,3 and Szunyorgh had only one case where bleeding was the presenting sign.7

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