Year 2014 / Volume 106 / Number 8
Digestive Diseases Image
Necrotic left colitis due to hot water enema

542-543

Miguel ángel Jiménez-Ballester, Paloma Bebia-Conesa, Mónica Mengual-Ballester, María Carrillo-García, Joana Miguel-Perelló, Enrique Pérez-Cuadrado Martínez y José Luis Aguayo-Albasini

Abstract
77-year-old man was admitted to emergencies for abdominal pain after instillation of a hot water enema in his home.
On admittance he had a fever of 38 °C, an affected general status, leucocytosis and signs of peritoneal irritation in the lower hemiabdomen. Abdominal CT showed a transmural thickening of the rectosigmoid wall (Fig. 1).
Diagnosed with colitis due to scalding he received a rectosigmoidoscopy at 72 hours (Fig. 2), which from the rectosig- moid junction revealed a necrotic mucosa extending some 15-20 cm. After making good progress he was discharged on the 15th day after admittance.
A month later, the patient presented with rectal tenesmus and episodes of diarrhoea. Colonoscopy revealed an impass- able stricture, 3 cm long and some 10 cm from the anus. After two sessions of endoscopic balloon dilatation, which was clinically ineffective, insertion of a biodegradable stent (BDS) was indicated (SX ELLA-BA Stent, Ella CS, Hradec Kral- ove, Czech Republic). This was fitted 3 months after admittance (Fig. 3) and the patient was asymptomatic a week after insertion and three months (Fig. 4) after degradation of the biodegradable stent (BDS).
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Miguel ángel Jiménez-Ballester, Paloma Bebia-Conesa, Mónica Mengual-Ballester, María Carrillo-García, Joana Miguel-Perelló, Enrique Pérez-Cuadrado Martínez y José Luis Aguayo-Albasini. Necrotic left colitis due to hot water enema. 542-543


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