Laparoscopic Exploration Converted to Laparotomy in a Case of Rectal Perforation and Peritonitis After Administration of Enema

Laparoscopy is the preferred surgical approach to several ailments because it permits accurate and efficient diagnosis and treatment. In abdominal conditions, the clinician may accomplish both treatment components - exploration for identification of the causative pathology and the conduction of a proper operation through laparoscopy. There is an ongoing debate of peritonitis as a contraindication to this approach. Laparoscopy has been widely accepted in many subspecialties over the last decade. Peritonitis is usually treated by a conventional open surgery which has a significantly high morbidity and mortality rate. In the present case, a 24-year-old male presented to the emergency unit of our facility with constipation for the past week, along with the inability to urinate with suprapubic pain and tenderness. The patient developed severe abdominal pain within an hour of receiving an enema injection. The patient was started on broad-spectrum antibiotics due to suspected peritonitis and later sent for imaging studies with urgent surgical consultation. The patient remained in the hospital for a few days and was then discharged after a week of hospital administration. It is worth mentioning that therapeutic laparoscopy may be considered in select cases of abdominal trauma. It offers more advantages over laparotomy, including reduced complication rate, length of stay, and mortality.