Radiological manifestations of ritual-enema-induced colitis

Most South African urban Blacks consult witchdoctors. In order to effect cures the witchdoctors often use enemas containing various ingredients. These enemas may result in complications, some of which may be fatal. The radiological manifestations of ritual-enema-induced colitis are described. The acute radiological abnormalities include segmental toxic dilatation, necrotising colitis, pseudopolypoid formation, ulcer formation, penetration and perforation. The chronic manifestations are loss of bowel calibre, skip stricture formation, diffuse stricture formation and loss of the normal haustral pattern. The spectrum of radiological appearances is both wide and kaleidoscopic, and may mimic many other colonic diseases.