Rectal gangrene: a complication of phosphate enema

Three cases of rectal gangrene are reported. All cases were compromised with intercurrent illnesses and all patients had complicated haemorrhoids before the gangrene developed. Rectal gangrene as a complication of haemorrhoids is rare and, whereas reports have suggested that this complication is due to nozzle injury, we believe that it may be due to a direct necrotizing effect of the phosphate on the rectum. We no longer recommend its use in compromised patients.