Retroperitoneal abscess after transanal minimally invasive surgery: case report and review of literature

Abstract

Abscesses are a rare complication of transanal minimally invasive surgery and transanal endoscopic micro surgery. Reported cases have been in the rectal and pre-sacral areas and have been managed with either antibiotics alone or in conjunction with laparotomy and diverting colostomy. We report a case of a large retroperitoneal abscess following a Transanal minimally invasive surgery full thickness rectal polyp excision. The patient was successfully managed conservatively with antibiotics and a percutaneous drain. Retroperitoneal infection should be included in a differential diagnosis following a Transanal minimally invasive surgery procedure as the presentation can be insidious and timely intervention is needed to prevent further morbidity.

Local Excision for the Management of Early Rectal Cancer

“…Interventional radiology (IR) development, together with the extension of indications for percutaneous drainage, has progressively replaced the need for surgical revision in a large part of retroperitoneal and pelvic collections. Generally, retroperitoneal abscess management strategies include conservative treatment with antibiotics in association with radiologically guided percutaneous drains, versus traditional surgical exploration with abscess drainage and eventually fecal diversion [44,63,64,66,67]. The need for protective stoma should be evaluated and considered particularly in relation to the abscess extension and patients' septic state.…”