title: Emergency surgery for epidural abcess secondary to sacral fistula after laparoscopic proctectomy.
abstract: A 61-year-old man presented via the emergency department with a few days history of abdominal and colic occlusion symptoms. He presented signs of sepsis, midline lumbar spine tenderness and reduced hip flexion. Computer tomography of the abdomen and pelvis showed a presacral collection contiguous with the posterior part of the colo-rectal anastomosis, and MRI lumbar spine revealed abscess invation into the epidural space. He underwent a laparotomy with washout of the presacral abscess and a colostomy with a prolonged course of intravenous antibiotic therapy. At 3 weeks after initial presentation he had made a full clinical recovery with progressive radiological resolution of the epidural abscess. The objective of the case report is to highlight a unique and clinically significant complication of a rare post-operative complication after rectal surgery and to briefly discuss other intra-abdominal sources of epidural abscess.
authors.affiliation: Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France menahem-b@chu-caen.fr.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Zeitoun
authors.affiliation: Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Menahem
authors.affiliation: Department of Radiology, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Fohlen
authors.affiliation: Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France.
authors.forename: Gil
authors.initials: G
authors.lastname: Lebreton
authors.affiliation: Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Lubrano
authors.affiliation: Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Alves