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Transanal gauze packing to manage massive presacral bleeding secondary to prescral abscess caused by rectal anastomotic leakage: a novel approach.

Yoo BE, Lee DW, Lee SW, Kwak JM, Kim J, Kim SH - Ann Surg Treat Res (2015)

Bottom Line: Anastomotic leakage following rectal resection is a serious and fearful complication, and may cause presacral abscess and/or peritonitis.To our knowledge, massive hematochezia secondary to presacral abscess caused by anastomotic leakage has not yet been reported in the literature.We observed this rare and life-threatening complication in three patients who were successfully treated with a simple but effective transanal gauze packing technique.

View Article: PubMed Central - PubMed

Affiliation: Colorectal Division, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Anastomotic leakage following rectal resection is a serious and fearful complication, and may cause presacral abscess and/or peritonitis. To our knowledge, massive hematochezia secondary to presacral abscess caused by anastomotic leakage has not yet been reported in the literature. We observed this rare and life-threatening complication in three patients who were successfully treated with a simple but effective transanal gauze packing technique.

No MeSH data available.


Related in: MedlinePlus

One roll of Vaseline-coated gauze.
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Figure 2: One roll of Vaseline-coated gauze.

Mentions: The patient was urgently brought to an operating room and placed in the lithotomy position under local perianal block. When an anal retractor was inserted into the anal canal to expose the anastomotic site, a large amount of blood gushed out from the presacral space through a tissue disruption on the posterior anastomotic line. Even after evacuation of the hematoma and saline irrigation, individual clipping or suturing to control the bleeding was not possible because of diffuse and massive hemorrhage from the presacral space. Therefore, several pieces of Spongostan (an absorbable gelatin tissue hemosealant) and rolls of Vaseline-coated gauze (Fig. 2) were packed into the presacral space until hemostasis (Fig. 3). The tip of the rolled gauze was brought out through the anus for easy removal later. No further bleeding was noted in the anus after this procedure.


Transanal gauze packing to manage massive presacral bleeding secondary to prescral abscess caused by rectal anastomotic leakage: a novel approach.

Yoo BE, Lee DW, Lee SW, Kwak JM, Kim J, Kim SH - Ann Surg Treat Res (2015)

One roll of Vaseline-coated gauze.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384289&req=5

Figure 2: One roll of Vaseline-coated gauze.
Mentions: The patient was urgently brought to an operating room and placed in the lithotomy position under local perianal block. When an anal retractor was inserted into the anal canal to expose the anastomotic site, a large amount of blood gushed out from the presacral space through a tissue disruption on the posterior anastomotic line. Even after evacuation of the hematoma and saline irrigation, individual clipping or suturing to control the bleeding was not possible because of diffuse and massive hemorrhage from the presacral space. Therefore, several pieces of Spongostan (an absorbable gelatin tissue hemosealant) and rolls of Vaseline-coated gauze (Fig. 2) were packed into the presacral space until hemostasis (Fig. 3). The tip of the rolled gauze was brought out through the anus for easy removal later. No further bleeding was noted in the anus after this procedure.

Bottom Line: Anastomotic leakage following rectal resection is a serious and fearful complication, and may cause presacral abscess and/or peritonitis.To our knowledge, massive hematochezia secondary to presacral abscess caused by anastomotic leakage has not yet been reported in the literature.We observed this rare and life-threatening complication in three patients who were successfully treated with a simple but effective transanal gauze packing technique.

View Article: PubMed Central - PubMed

Affiliation: Colorectal Division, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Anastomotic leakage following rectal resection is a serious and fearful complication, and may cause presacral abscess and/or peritonitis. To our knowledge, massive hematochezia secondary to presacral abscess caused by anastomotic leakage has not yet been reported in the literature. We observed this rare and life-threatening complication in three patients who were successfully treated with a simple but effective transanal gauze packing technique.

No MeSH data available.


Related in: MedlinePlus