Severe Acute Proctocolitis Caused by a Self-Administered Vodka Enema

  • Takeda Munekazu
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Natori Keiko
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Moroi Ryuichi
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Harada Tomoyuki
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Yaguchi Arino
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • Inagaki Nobuhiro
    Emergency Department, Oita City Medical Association's Almeida Memorial Hospital

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  • 経肛門的にウオッカを注入し発症した化学性(アルコール性)直腸結腸炎の1例

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Abstract

We report the case of a 37-year-old woman with severe acute proctocolitis and metabolic acidosis with loss of consciousness caused by a self-administered alcohol enema. The patient had a 10-year history of bipolar disorder. She was unconscious and in shock at arrival in the emergency room. After resuscitative procedures, a colonoscopy performed to determine the cause of the rectal bleeding showed severe inflammatory changes of the mucosa extending from the rectum to the descending colon, suggestive of ischemic colitis. She regained consciousness on the second day. On day 8, a repeat colonoscopy revealed healing of the rectum and sigmoid colon. We continued to treat the patient conservatively. On day 29, colonoscopy and radiography revealed inflammatory and stenotic changes of the descending and transverse colon. We performed a temporary colostomy on the right side of the transverse colon and the patient was discharged 23 days later. This is a rare case of severe and extensive proctocolitis caused by a self-administered alcohol enema.

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