Fulminant acute colitis following a self-administered hydrofluoric acid enema.
A 33-yr-old white male presented with bloody diarrhea, leukocytosis, and left lower quadrant direct and rebound tenderness after a self-administered concentrated hydrofluoric acid enema while intoxicated from intranasal cocaine administration. Intraoperative flexible sigmoidoscopy and a gastrografin enema revealed severe mucosal ulceration and edema in the rectum and sigmoid colon. Laparotomy revealed an ulcerated, necrotic, and purulent sigmoid colon and intraperitoneal pus. The patient underwent a limited sigmoid resection and a Hartman procedure. Five months later, the patient presented with a rectal stricture which was resected. This case demonstrates that a hydrofluoric acid enema can cause fulminant acute colitis and chronic colonic strictures.
Cappell
M S
MS
Department of Medicine, UMDNJ-Robert Wood Johnson (Rutgers) Medical School, New Brunswick.
Simon
T
T
D000208:Acute Disease; D000328:Adult; D003042:Cocaine; D003092:Colitis / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D003108:Colonic Diseases / Q000209:etiology; D003251:Constriction, Pathologic; D004733:Enema / Q000009:adverse effects*; D006801:Humans; D006858:Hydrofluoric Acid / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D012651:Self Medication; D019966:Substance-Related Disorders / Q000150:complications*
D003042:Cocaine; D006858:Hydrofluoric Acid