A case of perforation of rectum due to self-administered enema in a pregnant woman

Anjali Rani, Puneet Gupta


A 23 year old primigravida at 35 weeks gestation presented with pain abdomen, fever and dissension of abdomen. Initially patient was managed conservatively at peripheral centre for two days and then reported to our hospital. An ultrasound done which shows collection inside peritoneal cavity and perforation was suspected. Decision of laparotomy was done. First caesarean section was done and a single live male baby born weighing 2.4 kg born. Then on exploration a small perforation in rectum was found and it was repaired by surgeon. But they found two more perforations and colostomy was done. On taking detailed history patient told that she-herself administered enema because of constipation. In post op period patient expired because of septicemia and ARDS.


Perforation, Rectum, Pregnancy, Enema

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Klein RR, Scarborough RA. Traumatic perforations of the rectum and distal colon. Am J Surg. 1953;86:515.

Andrews EW. Pneumatic rupture of the intestine: a new type of industrial accident. Surg Gynaecol Obstet. 1911;12:63.

Charles G. Roland, Arnold G. Rogers. Rectal perforations after enema administration. Can Med Assoc J. 1959 Nov;81(10):815-8.

Kume K, Watanabe T, Oshima J, Yoshikawa I, Harada M. Rectal perforation caused by mesalazine enema in a patient with ulcerative colitis. Endoscopy. 2014;46(Suppl 1) UCTN:E190.

Kalkan IH, Oztas E, Yildiz H, Beyazit Y, Suvak B, Boyabatli M. Rectal perforation as a result of self-administration of retrograde enema in an elderly dementia patient. Geriatr Gerontol Int. 2012 Jul;12(3):564-5.

Mori H, Kobara H, Fujihara S, Nishiyama N, Kobayashi M, Masaki T, et al. Rectal perforation and fistulae secondary to a glycerin enema: closure by over-the-scope-clip. World J Gastroenterol. 2012 Jun;18(24):3177-80.

Tanswell IJ, Irfan K, Kossakowski T, Townson G. Rectal perforation in ulcerative colitis: complication of an enema tip. Gastrointes Endosc. 2009 Feb;69(2):344.