We have experienced a case of rectovesicofistula after a glycerin enema performed as a preparation of colonofiberscopy for polypectomy.
A 73-year-old man had a glycerin enema as a preparation of colonofiberscopy for polyps found by barium enema in some other hospital. He had a severe perianal pain diverging to his penis right after the enema. In spite of the injury to the rectal wall, he had a clipping closure under colonoscopy. Two weeks later, he was admitted to our hospital because of fecalurea, urine-mixed stool and pyrexia (39 centigrade). Colonoscopy and cystoscopy revealed a rectovesicofistula. Gastrographin enema and computed tomography revealed a perirectal abscess. We repaired the rectum and urinary bladder, built a diverting loop colostomy on the sigmoid colon, and drainaged the perirectal abscess operatively. The repaired sites were under good control after the operation.
Glycerin enemas are daily in usage in clinical scenes, and their rectal penetrations are rare complications. They sometimes develop some severe complications if adequate therapy in lacked. Perirectal abscesses should be drainaged as soon as possible after rectal injuries to avoid rectovesicofistulas.