J Korean Soc Coloproctol.  2008 Aug;24(4):298-301. 10.3393/jksc.2008.24.4.298.

Rectal Perforation after Anorectal Manometry Following Preoperative Chemoradiotherapy and Low Anterior Resection: Report of a Cases

• Jeong WK
• Chung TS
• Lim SW
• Park JW
• Lim SB
• Choi HS
• Jeong SY

• KMID: 2101463
• DOI: http://doi.org/10.3393/jksc.2008.24.4.298

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.

Keyword

Anorectal manometry; Rectal perforation; Radiotherapy

MeSH Terms

Anti-Bacterial Agents
Chemoradiotherapy
Drainage
Fasciitis
Fistula
Humans
Ileostomy
Male
Manometry
Middle Aged
Rectal Neoplasms
Rectum
Anti-Bacterial Agents