{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T22:59:35Z","timestamp":1768431575405,"version":"3.49.0"},"reference-count":4,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"content-version":"vor","delay-in-days":295,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Enema examination is considered safe, but in rare cases, complications may result. Here, we report a rare case of iatrogenic bowel perforation during enema examination through a colostomy without leakage of contrast agent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>A 36-year-old man who had undergone a sigmoid loop colostomy was diagnosed with ulcerative colitis. A bowel enema through a colostomy was performed by nurses and radiological technologists. During the procedure, a balloon catheter was inserted into the proximal lumen of the colostomy, and the balloon was inflated. The patient developed severe abdominal pain a few minutes following withdrawal of the catheter. Computed tomography showed intraperitoneal free air, although contrast agent leakage into the intraperitoneal cavity was not observed. The patient underwent emergency laparotomy. Intraoperatively, there was a 3-cm bowel perforation just inside the colostomy where the inflated balloon was pressing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The perforation site may have been sealed by the inflated balloon during the enema examination. In addition, the patient maintained a supine position during and after the examination. This led to contrast agent accumulating on the dorsal side and not leaking out from the perforation site after the balloon was deflated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Iatrogenic bowel perforation can occur without leakage of contrast agent during enema examination through a colostomy, and the examination should be performed under the supervision of an attending doctor. In the case of an enema examination through a colostomy, clinicians must be aware of the possibility of bowel perforation even if leakage of contrast agent is not observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.10.101","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T02:15:26Z","timestamp":1603505726000},"page":"36-38","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Bowel perforation during enema examination through a colostomy without leakage of contrast agent"],"prefix":"10.1097","volume":"77","author":[{"given":"Kaoru","family":"Katano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Furutani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chikashi","family":"Hiranuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Hattori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Doden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Hashidume","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-10-20260114","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/0363-0188(91)90017-V","article-title":"Recognition and prevention of barium enema complications","volume":"20","author":"Williams","year":"1991","journal-title":"Curr. Probl. Diagn. Radiol"},{"key":"R2-10-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R3-10-20260114","first-page":"766","article-title":"Barium peritonitis--following barium enema of the proximal colon through a colostomy","volume":"58","author":"Liew","year":"2003","journal-title":"Med. J. Malaysia"},{"key":"R4-10-20260114","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1515\/med-2020-0037","article-title":"Delayed bowel perforation after routine distal loopogram prior to ileostomy closure","volume":"15","author":"Poh","year":"2020","journal-title":"Open Med. (Wars"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220309792?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220309792?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.10.101","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:08:36Z","timestamp":1768396116000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.10.101"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":4,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.10.101","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}