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Herbal enema: At the cost of colon.

Prasad P, Tantia O, Patle NM, Mukherjee J - J Minim Access Surg (2012)

Bottom Line: It rarely requires blood transfusion or subtotal colectomy.Patient was managed successfully with emergency total laparoscopic colectomy.Post-operative recovery of the patient was excellent.

View Article: PubMed Central - PubMed

Affiliation: Department of Minimal Access and Bariatric Surgery, ILS Hospital, Salt Lake City, Kolkata, India.

ABSTRACT
Various colonic side-effects of herbal enema have been reported in literature ranging from mild abdominal discomfort to self-limiting haemorrhagic colitis. It rarely requires blood transfusion or subtotal colectomy. We report a 57-year-old male patient developing severe ileo-colitis with persistent massive rectal bleeding immediately after herbal enema administration for the treatment of chronic constipation and was resistant to conservative management. Patient was managed successfully with emergency total laparoscopic colectomy. Post-operative recovery of the patient was excellent.

No MeSH data available.


Related in: MedlinePlus

Intraoperative view showing an inadvertent perforation in edematous friable colon
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Figure 2: Intraoperative view showing an inadvertent perforation in edematous friable colon

Mentions: We gave the patient a trial of conservative management because the condition was not permissible to withstand a major abdominal surgery. Conservative management did not work and once again patient developed massive lower gastrointestinal bleed bringing haemoglobin down to 4.9 g%. Patient was planned for emergency laparoscopic total colectomy. On laparoscopy, there was evidence of mild ascites, thick oedematous inflamed and friable large bowel and distal 30 cm of ileum. Large bowel was very friable and developed 3 small inadvertent perforations by bowel holding grasper during dissection and manipulation of colon [Figure 2]. The perforations were managed by intracorporeal sutures to avoid peritoneal contamination. Total colon with distal inflamed ileum was resected laparoscopically. Hartmann procedure was done with end ileostomy at right spino-umbilical line. Specimen was retrieved by a small Pfannenstiel incision. The patient developed hyponatremia and paralytic ileus in early postoperative period that were managed conservatively. Oral liquids were started on postoperative day (POD) 3 and after that stoma started functioning. There was no wound infection. Drains were removed on POD5 and patient was discharged on POD 7 with advice of restoration of bowel continuity after 8-10 weeks.


Herbal enema: At the cost of colon.

Prasad P, Tantia O, Patle NM, Mukherjee J - J Minim Access Surg (2012)

Intraoperative view showing an inadvertent perforation in edematous friable colon
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3401717&req=5

Figure 2: Intraoperative view showing an inadvertent perforation in edematous friable colon
Mentions: We gave the patient a trial of conservative management because the condition was not permissible to withstand a major abdominal surgery. Conservative management did not work and once again patient developed massive lower gastrointestinal bleed bringing haemoglobin down to 4.9 g%. Patient was planned for emergency laparoscopic total colectomy. On laparoscopy, there was evidence of mild ascites, thick oedematous inflamed and friable large bowel and distal 30 cm of ileum. Large bowel was very friable and developed 3 small inadvertent perforations by bowel holding grasper during dissection and manipulation of colon [Figure 2]. The perforations were managed by intracorporeal sutures to avoid peritoneal contamination. Total colon with distal inflamed ileum was resected laparoscopically. Hartmann procedure was done with end ileostomy at right spino-umbilical line. Specimen was retrieved by a small Pfannenstiel incision. The patient developed hyponatremia and paralytic ileus in early postoperative period that were managed conservatively. Oral liquids were started on postoperative day (POD) 3 and after that stoma started functioning. There was no wound infection. Drains were removed on POD5 and patient was discharged on POD 7 with advice of restoration of bowel continuity after 8-10 weeks.

Bottom Line: It rarely requires blood transfusion or subtotal colectomy.Patient was managed successfully with emergency total laparoscopic colectomy.Post-operative recovery of the patient was excellent.

View Article: PubMed Central - PubMed

Affiliation: Department of Minimal Access and Bariatric Surgery, ILS Hospital, Salt Lake City, Kolkata, India.

ABSTRACT
Various colonic side-effects of herbal enema have been reported in literature ranging from mild abdominal discomfort to self-limiting haemorrhagic colitis. It rarely requires blood transfusion or subtotal colectomy. We report a 57-year-old male patient developing severe ileo-colitis with persistent massive rectal bleeding immediately after herbal enema administration for the treatment of chronic constipation and was resistant to conservative management. Patient was managed successfully with emergency total laparoscopic colectomy. Post-operative recovery of the patient was excellent.

No MeSH data available.


Related in: MedlinePlus