A 45-year-old man was admitted to our hospital because of melena. He had intrarectally self-administered 100ml of Shochu (a kind of Japanese liquor, 35% ethanol) followed by about 200ml of water as his sexual practice. This enema was performed twice; i. e. once a day over a two-day period. After the administration of the enema on the 2nd day, he began having melena. An emergent colonoscopy revealed redness, edema, and diffuse erosion or ulcer with marked friability and hemorrages. These changes were confined to 15cm from the anal verge. Histological findings showed complete sloughing off of the surface epithelium, destruction of the glands and blood vessels, and interstitial edema with non-specific neutrophilic infiltration. These microscopic appearances resembled ischemic colitis, but these injuries were more intense in the superficial layar of the mucosa. He was treated conservatively without antiinflammatory drugs such as corticosteroids, mesalamine and other medications. Anal bleeding disappeared entirely on the 7th hospital day. He refused to have a follow-up colonoscopy, but he has had no recurrence of melena up to the present day.
CITATION STYLE
Kawamura, O., Sawada, T., Hara, T., Kodama, T., Sanada, H., Simazaki, S., … Matsushita, K. (2002). Chemical proctocolitis due to alcohol (Shochu) enema. Gastroenterological Endoscopy, 44(6), 1019–1022.
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