Madhala O, Greif F, Cohen M, Lelcuk S
Department of Surgery B, Rabin Medical Center (Beilinson Campus), and Tel Aviv University School of Medicine, Tel Aviv, Israel.
Dig Surg. 1998;15(3):270-2. doi: 10.1159/000018627.
Current methods of large bowel preparation prior to colonoscopy, barium enema and surgery are extremely effective in cleaning the bowel of feces. We rationalize, therefore, that under these conditions rectal perforations secondary to barium and cleansing enema could be treated expectantly, namely either defer or completely avoid immediate surgery.
Two female patients with major rectal perforations secondary to barium and cleansing enema who had thoroughly prepared large bowel were treated conservatively.
Both patients did well without surgery and were discharged without any long-term sequela.
Since a large number of iatrogenic perforations of the rectum occur in patients with well-prepared and clean bowel immediate surgery can be deferred or avoided all together without compromising them.
目前结肠镜检查、钡灌肠和手术前进行大肠准备的方法在清洁肠道粪便方面极为有效。因此，我们推断，在这些情况下，由钡剂和清洁灌肠继发的直肠穿孔可以保守治疗，即推迟或完全避免立即手术。
两名因钡剂和清洁灌肠继发严重直肠穿孔且大肠已充分准备的女性患者接受了保守治疗。
两名患者均未进行手术，恢复良好，出院时无任何长期后遗症。
由于大量医源性直肠穿孔发生在肠道准备良好且清洁的患者中，因此可以推迟或完全避免立即手术，而不会对患者造成不利影响。
