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Clinical cases and animal experiments show that high-fat (HF) diet is involved in inflammatory bowel disease (IBD), but the specific mechanism is not fully clear. A close association between long-term HF-induced obesity and IBD has been well-documented. However, there has been limited evaluation of the impact of short-term HF feeding on the risk of intestinal inflammation, particularly on the risk of disrupted metabolic homeostasis.

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Background/purpose: Enemas have become a common practice for treating fecal incontinence and severe constipation. Several patients receiving enemas complained of severe, colicky, abdominal pain during enema administration and complained that the duration for fluid to pass was progressively increasing. Contrast studies showed a startling picture of severe right colon dilatation and a spastic, narrow, left colon.

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Hydrogen peroxide is a disinfectant commonly used for cleansing superficial wounds due to its oxidizing capacity. In the past, it has also been used for the management of meconium ileus in children as the oxidizing action of hydrogen peroxide potentiates peristalsis that relieves ileus or fecal impaction. The potential dangers were unknown till Pumphrey, in 1951, described the harmful effects of its use as an enema.

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Mechanical enemas can lead to intestinal mucosal injuries and bowel barrier damage, presenting as electrolyte disturbances and functional intestinal disorders. Most researchers believe that the mechanism of injury is related to osmolality, volume and temperature of the solution, infusion pressure, and the composition of the enema tube. We hypothesized that the pH of the enema solution may also contribute to intestinal damage.

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Phased surgical treatment of barium enema-induced rectal injury and retention of barium in the pelvic floor space.

Ann Transl Med

October 2014

1 Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China ; 2 Department of Gastrointestinal Surgery, Shenzhen People's Hospital & Second Clinical Medical College of Jinan University, Shenzhen 518020, China ; 3 Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.

Iatrogenic injuries caused by barium enema are rarely reported. Following a phased surgical protocol for up to one year, we have successfully treated a patient with rectal injury and severe infection of the pelvic floor space complicated with retention of large amounts of barium and vaginal fistula. In this article, the phased surgery planning for the treatment of rectal injury complicated with vaginal fistula is discussed in terms of the pros and cons, and the observed effect and evolution of barium retained in the pelvic floor space are described.

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