Open AccessIatrogenic colorectal perforation induced by anorectal manometry: Report of two cases after restorative proctectomy for distal rectal cancer
Author(s) -
Jun Seok Park,
Sung Bum Kang,
Duck Woo Kim,
Na Young Kim,
Kyung Ho Lee,
Young Hoon Kim
Publication year - 2007
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v13.45.6112
Subject(s) - medicine , perforation , ileostomy , colorectal cancer , anastomosis , anal canal , rectum , surgery , anorectal manometry , radiology , cancer , constipation , materials science , punching , metallurgy
There are no reports regarding perforation of the colorectum induced by anorectal manometry. We report two cases of colorectal perforation that occurred during manometry in the patients undergoing restorative proctectomy for distal rectal cancer. In the first patient, computed tomography showed an extraperitoneal perforation in the pelvic cavity and a rupture of the rectal wall. A localized perforation into the retroperitoneum was managed conservatively. In the second patient, a 3 cm linear colon rupture was detected above the anastomotic site. A primary closure of the perforated colon and proximal ileostomy were conducted, but the patient died 2 wk later. We hypothesize that the perforation induced by anorectal manometry may be associated with the relative weakening of the proximal bowel wall due to anastomosis, decreased compliance, and abnormal rectal sensation. We suggest that measurement of the maximum tolerable volume should not be routinely performed after restorative proctectomy for distal rectal cancer.