[Injuries to the rectum in diagnostic and therapeutic measures (author's transl)].MMW Munch Med Wochenschr. 1975 Feb 21; 117(8):291-2.MM
From 1955 to 1973, 28 anus praeter or rectal perforations were observed in the Chirurgische Universitätsklinik Erlangen. Ten of these patients died. The perforation of the intestine was already noted at the time of injury in 14, in 14 it deteriorated until a peritonitis at the end of three days on the average required laparotomy. The perforations arose mainly through rectoscopy or enemas. Such everday measures need care, in particular to stop the manipulation when the patient complains of pain. If there is the slightest suspicion, visualize the point of injury with a water soluble contrast medium.