Rectal Perforation after Anorectal Manometry Following Preoperative Chemoradiotherapy and Low Anterior Resection: Report of a Cases. |
Jeong, Woon Kyung , Chung, Tae Sung , Lim, Sang Woo , Park, Ji Won , Lim, Seok Byung , Choi, Hyo Seong , Jeong, Seung Yong |
1Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, Goyang, Korea. syjeong@ncc.re.kr 2Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. |
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Abstract |
Anorectal manometry is widely used to evaluate anorectal function. Few reports have described complications resulting from this procedure. A 47-year-old male underwent preoperative chemoradiotherapy and a low anterior resection for rectal cancer. The patient underwent anorectal manometry at postoperative 8 months. A rectal perforation was diagnosed shortly thereafter. The patient was initially managed conservatively using percutaneous drainage and parenteral antibiotics and then discharged on day 60 after the event. One month later, a colo-cutaneous fistula and expanding abdominal fasciitis developed. The patient underwent surgical exploration, drainage, resection of the rectum including the fistula, and redo-coloanal anastomosis with a diverting ileostomy. The patient discharged without complications on postoperative day 25. Anorectal manometry should be performed with particular care in patients who have undergone radiotherapy and anastomosis at the rectum. |
Key Words:
Anorectal manometry; Rectal perforation; Radiotherapy |
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