Dor retal persistente após retossigmoidectomia: relato de caso

Abstract

SUMMARY BACKGROUND AND OBJECTIVES:Postoperative chronic abdominal pain still lacks pathophysiological studies, being described after Cesarean section, inguinal hernia, videolaparoscopy and cholecystectomy. In lower abdomen, chronic proctalgia has been described after hemorrhoidectomy and is characterized as pain at evacuation followed by fecal urgency. Persistent postoperative pain after videolaparoscopic rectosigmoidectomy is uncommon. This study aimed at reporting a case of persistent postoperative pain after videolaparoscopic rectosigmoidectomy, controlled with bilateral anesthetic block of the hypogastric plexus. CASE REPORT: Female patient, 54 years old, submitted to videolaparoscopic rectosigmoidectomy with transverse-rectal colon anastomosis. In the immediate postoperative period she evolved with tenesmus, continuous and severe pain with occasional burning. Non-steroid analgesics would not relieve pain. Evaluation has not shown surgical complications and she was referred to the pain control team. Radioscopy-guided transdiscal bilateral diagnostic blockade of upper hypogastric plexus was induced with 4 mL of 1% lidocaine (without vasoconstrictor) in L 5 /S 1 which has in-