Iatrogenic colorectal perforation induced by anorectal manometry:Report of two cases after restorative proctectomy for distal rectal cancer

作     者：Jun-Seok Park Sung-Bum Kang Duck-Woo Kim Na-Young Kim Kyoung-Ho Lee Young-Hoon Kim 

作者机构：Department of Surgery Chung-Ang University Hospital Seoul National University Bundang Hospital Seongnam-si Gyeonggi-do 463-707 Korea Department of Surgery Seoul National University Bundang Hospital Seongnam-si Gyeonggi-do 463-707 Korea Department of Internal Medicine Seoul National University Bundang Hospital Seongnam-si Gyeonggi-do 463-707 Korea Department of Diagnostic Radiology Seoul National University Bundang Hospital 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2007年第13卷第45期

页      面：6112-6114页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Iatrogenic perforation Anorectal manometry Rectal cancer Low anterior resection 

摘      要：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 alter restorative proctectomy for distal rectal cancer.