title: Rectum perforation during transanal irrigation: a case story.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  Report a case of rectum perforation during transanal irrigation (TAI).
  
  
  METHODS
  Clinic for Spinal Cord Injuries, and Departments of Gastroenterological Surgery and Radiology.
  
  
  METHODS
  A 54-year-old woman with spinal cord lesion for 35 years emptied for years her bowel using oral laxative. This became more difficult and took more than 2 h three times a week with reflex stimulation after a chlysma. She wanted to try TAI, and went through the procedure with a nurse one time. The next time she performed the TAI by herself without difficulty. Two hours later she started shivering with a temperature at 38.3 degrees C with normal blood pressure (BP). At rectal exploration, a spoonful fresh blood was found. After another 2 h, she became septic and was transferred to a gastroenterological surgical department. An abdominal X-ray gave no suspicion of free air in the abdomen. Sigmoideoscopy showed 3-5 cm oral to the dentate line a 1 x 1 cm transmural circular lesion. A colon X-ray with water contrast showed a perforation of approximately 2 x 0.5 cm.
  
  
  CONCLUSIONS
  Even in experienced individuals who are proper trained, TAI can cause rectal perforation, which always have to be born in mind.
authors.affiliation: Clinic for Spinal Cord Injuries, Rigshospitalet & University of Copenhagen, Copenhagen, Denmark. finbs@rh.dk
authors.forename: F
authors.initials: F
authors.lastname: Biering-Sørensen
authors.forename: J
authors.initials: J
authors.lastname: Bing
authors.forename: P
authors.initials: P
authors.lastname: Berggreen
authors.forename: G M V
authors.initials: GM
authors.lastname: Olesen
mesh_terms: D001913:Bowen's Disease / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000139:chemically induced*; D054368:Laxatives / Q000009:adverse effects*; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000150:complications; D007507:Therapeutic Irrigation / Q000009:adverse effects*
chemical_list: D054368:Laxatives