Untoward Effects of Enemata in Congenital Megacolon

The problem of untoward reactions to enemata in cases of congenital megaclon has been discussed, and nine cases of such reactions presented. The evidence, although admittedly incomplete, seems to favor water intoxication as the basis of most of these reactions. Other possible etiologic factors are discussed. A routine for the prevention of syncope by the use of isotonic enema solutions in cases of congenital megacolon is advocated. The use of tap water or soapsuds enemas or of solutions containing potentially toxic substances such as magnesium sulfate is contraindicated in congenital megacolon.