Rectal perforations and fistulae secondary to a glycerin enema:Closure by over-the-scope-clip  

作　　者：Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Mitsuyoshi Kobayashi Tsutomu Masaki Kunihiko Izuishi Yasuyuki Suzuki 

机构地区：[1]Department of Gastroenterology and Neurology,Kagawa Medical University School of Medicine,Kagawa 761-0793,Japan [2]Department of Gastroenterological Surgery,Kagawa Medical University School of Medicine,Kagawa 761-0793,Japan

出　　处：《World Journal of Gastroenterology》2012年第24期3177-3180,共4页世界胃肠病学杂志（英文版）

摘　　要：Rectal perforations due to glycerin enemas(GE) typically occur when the patient is in a seated or lordotic standing position.Once the perforation occurs and peritonitis results,death is usually inevitable.We describe two cases of rectal perforation and fistula caused by a GE.An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE.Her case was further complicated by an abscess in the right rectal wall.The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE.In both cases,we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip(OTSC) procedure.These procedures resulted in dramatic improvement in both patients.Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure,respectively,in elderly patients who are in poor general condition.Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE.Rectal perforations due to glycerin enemas（GE） typically occur when the patient is in a seated or lordotic standing position.Once the perforation occurs and peritonitis results,death is usually inevitable.We describe two cases of rectal perforation and fistula caused by a GE.An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE.Her case was further complicated by an abscess in the right rectal wall.The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE.In both cases,we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip（OTSC） procedure.These procedures resulted in dramatic improvement in both patients.Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure,respectively,in elderly patients who are in poor general condition.Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE.

关 键 词：Rectal perforation Glycerin enema Abscesslavage Fistula closure Over-the-scope-clip 

分 类 号：R657.1[医药卫生—外科学]