Acid burns of the rectum and colon

The case of a patient with acid burns of the large bowel from a self-administered enema of 95 percent sulfuric acid solution is reported. The authors were unable to find a similar case in the English medical literature. The patient presented in metabolic acidosis, and flexible sigmoidoscopy was of limited value. Peritoneal signs warranted early laparotomy, which revealed coagulation necrosis of the anus, rectum, and colon up to the hepatic flexure without any free perforation. The extent of damage was more severe than seen in the upper digestive tract from acid ingestion. Juxtaposed small bowel and the appendix sustained serosal burns. Subtotal proctocolectomy and perineal resection were done and the patient made an uneventful recovery. Early laparotomy is warranted, irrespective of endoscopic findings, for appropriate surgical correction.