Untoward effects of enemata in congenital megacolon.

By MARY R. RICHARDS, M.D., AND ROBERT B. HIATT, M.D. New York City E PISODES of syncope varying from mild shock to rapid collapse and death frequently follow the administration of enemata in patients with congenital megacolon, particularly when the solution used is water, and when one of the parasympathomimetic drugs is given coincidentally. Such reactions have been previously described by one of the authors (R. B. H.) and were found to occur in approximately 60% of a series of 42 cases.1 A review of the literature on congenital megacolon for the past 10 years discloses little information on the subject, and no reports or warnings are to be found in the pediatric literature or textbooks. The striking improvement in the prognosis of this disease which has followed advances in surgical treatment makes general knowledge of this complication imperative in order that these tragic accidents may be prevented. For this reason a review of the subject and some illustrative case reports are presented.