Rectal burn caused by hot-water coffee enema.

A 29-year-old woman underwent a coffee enema with hot water to treat constipation. She quickly evacuated it because of lower abdominal pain; however, she developed chills and proctorrhagia a few hours afterward. The following day, she was referred to our hospital complaining of severe anal pain and hematochezia. Proctoscopy showed black necrotic mucosa and severe erosions of the lower rectum (A). The patient refused to be hospitalized and thus was cared for in the outpatient department. She was instructed to maintain a liquid diet and take a betamethasone suppository daily. Hematochezia continued until the second day of observation, after which bowel movements became normal; pain upon defecation continued. Although there was mild stenosis of the lower rectum induced by the circumferential ulcer and edema (B), the patient had a normal bowel movement and was taking a regular diet by the seventh day of observation. On the fifteenth clinical day, endoscopy showed improvement of the rectal erythema and stenosis (C). Anal pain disappeared on the twenty-ninth clinical day. The patient recovered without