Case Report
Spinal Cord (2009) 47, 266–267; doi:10.1038/sc.2008.95; published online 5 August 2008
Rectum perforation during transanal irrigation: a case story
F Biering-Sørensen1, J Bing1, P Berggreen2 and G M V Olesen3
- 1Clinic for Spinal Cord Injuries, Rigshospitalet & University of Copenhagen, Copenhagen, Denmark
- 2Department of Gastroenterology, Hillerød Hospital, Copenhagen, Denmark
- 3Department of Radiology, Hillerød Hospital, Copenhagen, Denmark
Correspondence: Dr F Biering-Sørensen, Clinic for Spinal Cord Injuries, TH2091, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, Copenhagen Ø DK-2100, Denmark. E-mail: finbs@rh.dk
Received 28 February 2008; Revised 18 June 2008; Accepted 5 July 2008; Published online 5 August 2008.
Abstract
Study design:
Case report.
Objectives:
Report a case of rectum perforation during transanal irrigation (TAI).
Setting:
Clinic for Spinal Cord Injuries, and Departments of Gastroenterological Surgery and Radiology.
Case report:
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 °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 
1 cm transmural circular lesion. A colon X-ray with water contrast showed a perforation of approximately 2 0.5 cm.
Conclusion:
Even in experienced individuals who are proper trained, TAI can cause rectal perforation, which always have to be born in mind.
Keywords:
transanal irrigation, bowel management, rectum perforation
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