Abstract
Case 1 : A 63-year-old man was admitted to our hospital with ischemic colitis. Following a glycerin enema administered in the standing position to treat constipation, he developed severe anal pain, melena, and hematuria. Anoscopy showed anorectal fistulae, and an abdominal computed tomography (CT) scan revealed increased perirectal fat and gas, leading to a diagnosis of rectal perforation caused by the glycerin enema. He was kept n. p. o and administration of antibiotics and Haptoglobin against hematuria to prevent renal failure helped repair his rectal injury. Thus, he was seen to improve with conservative therapy.
Case 2 : A 78-year-old man was admitted to a sanatorium with a cervical spine injury. Due to complaints of constipation over 5 days, a glycerin enema was administered in the sitting position in a toilet for nursing care, following which he had anal bleeding but no hematuria. Colonoscopy showed an injury to his lower rectum and an abdominal CT showed thickness and emphysema of the rectal wall with perirectal gas. He was kept n. p. o., and given infusion and antibiotics to repair his rectal injury. Rectal injury after accidental inappropriate administration of glycerin enema occasionally induces serious complications such as hemolysis, acute renal failure, pan-peritonitis among others. Therefore, glycerin enema must be administered carefully and judiciously.
