Rectal necrosis after a phosphate enema.

We describe a patient who developed rectal ulceration after an apparently minor injury caused during the administration of a 130 ml 'disposable' phosphates enema. Treatment included parenteral antibiotics and a colostomy. Minor degrees of injury by rectal procedures are common. Rectal necrosis is a complication of injury during the administration of phosphates enemata which, although rare, deserves greater awareness. Painless rectal bleeding may be the only sign of injury and is an indication for thorough and repeated rectal examinations and early intervention.