Retroperitoneal perforation of the rectum during double-contrast barium-enema examination: a life-threatening complication

Background. Rectal injuries during barium-enema are rare but life-threatening complications.

Case report. We present a case of an 82-year-old man in whom extensive retroperitoneal perforation of the rectum occurred during double-contrast barium-enema examination. The patient was revealed acute abdomen, difficulty in breathing and diffuse subcutaneous crepitus at the chest and neck area. The patient underwent a surgery because signs of peritonitis developed. We performed a Hartmann's procedure. The patient died 20 hours after the surgery due to a septic shock.

Conclusions. Prompt recognition and management of retroperitoneal perforation of the rectum are sine qua non in decreasing mortality.