title: Pneumoretroperitoneum and pneumomediastinum after Stapled Anopexy Is conservative treatment possible?
abstract: BACKGROUND
  Stapled anopexy is considered the gold standard in treating haemorroidal disease associated to mucosal prolapse, but severe complications have been described. Among these, a minimal anastomotic leakage may lead to gas spreading into surrounding soft tissues.
  
  
  METHODS
  We report the case of a 61 year old male who developed pneumoretroperitoneum and pneumomediastinun two days after a Stapled Anopexy. CT scans showed a minimal leakage with no abscess. The patient was successfully treated by bowel rest, antibiotics and total parenteral nutrition, avoiding surgical approach.
  
  
  CONCLUSIONS
  A minimal anastomotic leakage following Stapled Anopexy, when leading to air diffusion into soft tissues and not associated to abscess or peritonitis may be treated conservatively avoiding ileostomy or colostomy.
  
  
  BACKGROUND
  Anastomotic leakage, Pneumoretroperitoneum, Stapled Anopexy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Macchini
authors.forename: Angelo
authors.initials: A
authors.lastname: Guttadauro
authors.forename: Silvia
authors.initials: S
authors.lastname: Frassani
authors.forename: Matteo
authors.initials: M
authors.lastname: Maternini
authors.forename: Francesco
authors.initials: F
authors.lastname: Gabrielli
mesh_terms: D057868:Anastomotic Leak / Q000209:etiology / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D000072700:Conservative Treatment; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology / Q000628:therapy*; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D012188:Retropneumoperitoneum / Q000209:etiology / Q000628:therapy*; D017792:Surgical Stapling / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin