Kye Bong-Hyeon, Kim Hyung-Jin, Lee Kang Moon, Cho Hyeon-Min
Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.
J Korean Surg Soc. 2011 Nov;81(5):350-4. doi: 10.4174/jkss.2011.81.5.350. Epub 2011 Nov 1.
Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema.
热水灌肠引起的直肠烧伤仅有偶尔的报道，且大多数采用保守治疗。虽然直肠烧伤导致的顽固性直肠狭窄很少见，但可通过内镜干预或手术治疗。一名52岁女性曾使用各种灌肠方法治疗慢性便秘，最终自行进行了热水灌肠。此后，肛门疼痛和便秘加重，促使她前来我院就诊。尽管进行了包括内镜支架置入在内的各种非手术治疗，但其梗阻症状并未改善，内镜检查结果也未改变。因此，我们进行了腹腔镜直肠乙状结肠切除术及经肛门结肠肛管吻合术并做回肠转流术来治疗该疾病，结果其梗阻症状得到明显改善。诸如切除受累节段并吻合的矫正手术可能有助于缓解热水灌肠引起的顽固性直肠狭窄的梗阻症状。
