title: Colonic complications after toxic tribal enemas.
abstract: Tribal enemas obtained from traditional healers are used widely in Southern Africa for a variety of indications. Inclusion of injurious substances such as potassium dichromate may cause serious colonic and renal complications. Nine such patients, in seven of whom chromate use was confirmed, presented after a mean delay of 7.3 days. All patients had bloody diarrhoea and vomiting and three underwent major colonic resection, requiring a total of ten procedures. One patient suffered mechanical perforation of the rectum, with subsequent necrotizing fasciitis, necessitating rectal excision. Eight patients had acute renal failure and seven required dialysis. One patient died. At follow-up one patient has chronic renal failure and only three are completely well. Although local medical practitioners are aware of the problem, the challenge of preventing harmful cultural practices remains.
authors.affiliation: Department of Surgery, University of Cape Town, South Africa.
authors.forename: J P
authors.initials: JP
authors.lastname: Dunn
authors.forename: J E
authors.initials: JE
authors.lastname: Krige
authors.forename: R
authors.initials: R
authors.lastname: Wood
authors.forename: P C
authors.initials: PC
authors.lastname: Bornman
authors.forename: J
authors.initials: J
authors.lastname: Terblanche
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D003106:Colon / Q000473:pathology; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D004733:Enema / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007416:Intestinal Perforation / Q000209:etiology; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D011192:Potassium Dichromate / Q000009:adverse effects; D011859:Radiography; D012007:Rectum / Q000000981:diagnostic imaging
chemical_list: D011192:Potassium Dichromate