A 42-year-ole woman developed ischemic colitis shortly after the administration of a cleansing enema. As possible predisposing factor in out patient we assess treatment with contraceptives by parenteral route, started one year before her episode of bowel ischemia. To out knowledge, this is the first patient without underlying pathology with proven ischemic colitis secondary to a cleansing enema.
PIP: A 42-year-old woman was administered a cleansing enema to treat chronic constipation. Immediately after the procedure she developed intense pain in the abdominal region, nausea, vomiting, and rectal bleeding. The patient, who was in good general health, had been on contraceptive administration of Depo-Provera (150 mg each month) for 1 year. Radiological investigation, endoscopy and histopathological examinations revealed acute ischemic colitis. A left hemicolectomy was performed with colorectal anastomosis through laparotomy; the postoperative period was good and the patient was discharged in good health. The majority of cases of ischemic colitis occur in persons of advanced age, because of arteriosclerosis. In young female patients it is necessary to systematically investigate contraceptive use as a possible iatrogenic cause; surgery may be indicated in some cases.