Rectal Perforation after Anorectal Manometry Following Preoperative Chemoradiotherapy and Low Anterior

Received November 16, 2007, Accepted July 8, 2008 Correspondence to: Seung-Yong Jeong, Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea Tel: +82-31-920-2341, Fax: +82-31-920-2468 E-mail: [email protected] A portion of this article was presented as a poster at the 2007 fall meeting of the Korean Society of Coloproctology. 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. J Korean Soc Coloproctol 2008;24:298-301