Fulminant acute colitis following a self-administered hydrofluoric acid enema

Am J Gastroenterol. 1993 Jan;88(1):122-6.


A 33-yr-old white male presented with bloody diarrhea, leukocytosis, and left lower quadrant direct and rebound tenderness after a self-administered concentrated hydrofluoric acid enema while intoxicated from intranasal cocaine administration. Intraoperative flexible sigmoidoscopy and a gastrografin enema revealed severe mucosal ulceration and edema in the rectum and sigmoid colon. Laparotomy revealed an ulcerated, necrotic, and purulent sigmoid colon and intraperitoneal pus. The patient underwent a limited sigmoid resection and a Hartman procedure. Five months later, the patient presented with a rectal stricture which was resected. This case demonstrates that a hydrofluoric acid enema can cause fulminant acute colitis and chronic colonic strictures.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Cocaine*
  • Colitis / chemically induced*
  • Colitis / pathology
  • Colitis / surgery
  • Colonic Diseases / etiology
  • Constriction, Pathologic
  • Enema / adverse effects*
  • Humans
  • Hydrofluoric Acid / administration & dosage
  • Hydrofluoric Acid / adverse effects*
  • Male
  • Self Medication
  • Substance-Related Disorders / complications*


  • Cocaine
  • Hydrofluoric Acid