Rectal perforation secondary to surgical drains after low anterior resection: a report of two cases and review of the literature.
Routine pelvic drainage after resection of the rectum followed by immediate anastomosis is not only advisable but also essential for decreasing fluid accumulation and subsequent abscess formation. In spite of infrequency, complications secondary to placement of these surgical drains occur. Herein we report two cases of rectal perforation caused by prophylactic drainage of pelvic cavity after low anterior resection for rectal carcinoma. Postoperatively, both patients were found with discharge of faecal material from the surgical drains. Anastomotic dehiscence was tentatively impressed until a definite diagnosis was obtained. The drain tube penetrated into the rectal lumen without anastomotic leakage and that was ultimately confirmed by colonoscopy. The possibility of rectal perforation should be kept in mind when draining the pelvic cavity after low anterior resection for the rectal carcinoma. Furthermore, significance of colonoscopy in the early postoperative period should be emphasized.
Wang
Jaw-Yuan
JY
Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Shih Chuan 1st Road, Kaohsiung 807, Taiwan. cy614112@ms14.hinet.net
Hsieh
Jan-Sing
JS
Chen
Fang-Ming
FM
Lee
Li-Wei
LW
Hou
Ming-Feng
MF
Huang
Yu-Sheng
YS
Huang
Tsung-Jen
TJ
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003113:Colonoscopy; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000209:etiology*; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*