Pneumoretroperitoneum and pneumomediastinum after Stapled Anopexy. Is conservative treatment possible?

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Daniele Macchini
Angelo Guttadauro
Silvia Frassani
Matteo Maternini
Francesco Gabrielli

Abstract

INTRODUCTION: 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.


CASE REPORT: 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.


CONCLUSION: 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.

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How to Cite
Macchini, Daniele, et al. “Pneumoretroperitoneum and Pneumomediastinum After Stapled Anopexy. Is Conservative Treatment Possible?”. Annali Italiani Di Chirurgia, vol. 87, no. 5, Sept. 2016, pp. 456-60, https://annaliitalianidichirurgia.it/index.php/aic/article/view/2368.
Section
Case Report