{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:56:10Z","timestamp":1777312570451,"version":"3.51.4"},"reference-count":38,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>Introduction: Constipation is a common complaint. The elderly are five times more prone to constipation than young people because of the effects of medication, immobility, and a blunted urge to defecate. Many of these patients are demented, have cognitive deficits, or suffer from a psychiatric disorder.<\/jats:p>\n                  <jats:p>Colonic perforation caused by hydrostatic pressure is rare, and this typically occurs during fluoroscopic studies resulting when there is excessive intraluminal colonic pressure. Self-induced colonic perforation is even rarer.<\/jats:p>\n                  <jats:p>Case report: We report the case of a 95-year-old man who presented to the emergency department with an acute surgical abdomen and symptoms of sepsis. He had a history of longstanding constipation. He gave a history of frequent insertion of a rubber hose into his anal canal to relieve his constipation while rinsing his anus after defecation. After resuscitation, an emergency operation was performed, and sigmoid colon perforation was found in addition to pre-existing diverticular disease. Hartmann\u2019s procedure was performed after abdominal washout. Unfortunately, the patient died of multi-organ failure two days after surgery.<\/jats:p>\n                  <jats:p>Conclusion: Self-induced hydrostatic colonic perforation is rare. The consequence is fatal, especially in the elderly or in cases of delayed presentation.<\/jats:p>","DOI":"10.5339\/qmj.2021.14","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T05:31:13Z","timestamp":1619674273000},"source":"Crossref","is-referenced-by-count":0,"title":["A Case of Self-Induced Hydrostatic Colonic Perforation"],"prefix":"10.5339","volume":"2021","author":[{"given":"Hassan","family":"Ali Alzahrani","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia E-mail: hahassan@kku.edu.sa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"issue":"27:","key":"CIT0001","series-title":"J Pediatr Surg","first-page":"589\u201391","article-title":"Perforation during hydrostatic reduction of intussusception: proposed mechanism and review of the literature","author":"Bramson\n \nRT\n,","year":"1992"},{"issue":"102:","key":"CIT0002","series-title":"Ann Surg","first-page":"471\u20132","article-title":"Rupture of the sigmoid by hydrostatic pressure","author":"Walking\n \nA","year":"1935"},{"issue":"44:","key":"CIT0003","series-title":"J Emer Med","first-page":"344\u201348","article-title":"Colorectal perforation by self-induced hydrostatic pressure: a report of two cases","author":"Choi\n \nPW","year":"2013"},{"issue":"6:","key":"CIT0004","series-title":"Int J Gen Med","first-page":"323\u20138","article-title":"Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable","author":"Niv\n \nY\n,","year":"2013"},{"issue":"32:","key":"CIT0005","series-title":"Dis Colon Rectum","first-page":"759\u201364","article-title":"Perforation of the rectum and sigmoid colon during barium-enema examination. 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