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Pneumoretroperitoneum after procedure for prolapsed hemorrhoid.

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  • 1Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea.

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Summary

The Procedure for Prolapsed Hemorrhoids (PPH) can lead to rare but severe rectal perforation. This case report details the first Korean instance of pneumoretroperitoneum resulting from PPH staple-line dehiscence.

Keywords:
HemorrhoidPneumoretroperitoneumProlapsed hemorrhoid

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Area of Science:

  • Colorectal Surgery
  • Surgical Complications
  • Gastrointestinal Procedures

Background:

  • The Procedure for Prolapsed Hemorrhoids (PPH) is a widely adopted alternative to traditional hemorrhoidectomy, offering benefits like reduced pain and faster recovery.
  • Despite its advantages, rare but severe complications, including life-threatening events, have been reported following PPH over the last decade.
  • Rectal perforation, specifically from staple-line dehiscence, is a critical complication that can lead to extensive pelvic sepsis or pneumoretroperitoneum.

Purpose of the Study:

  • To report the first documented case in Korea of pneumoretroperitoneum.
  • To highlight the potential for severe complications arising from staple-line dehiscence after PPH.
  • To contribute to the understanding of rare adverse events associated with PPH.

Main Methods:

  • A case study approach was used.
  • Detailed clinical presentation, diagnostic findings, and management of a patient experiencing pneumoretroperitoneum post-PPH were analyzed.
  • Literature review on rectal perforation and pneumoretroperitoneum following PPH was conducted.

Main Results:

  • The patient developed pneumoretroperitoneum, a rare complication, attributed to staple-line dehiscence during PPH.
  • This complication led to significant pelvic sepsis, underscoring the severity of rectal perforation.
  • The case represents the initial Korean report of this specific PPH-related complication.

Conclusions:

  • Staple-line dehiscence following PPH can result in severe and life-threatening conditions like pneumoretroperitoneum.
  • Vigilance for rare but serious complications is crucial in patients undergoing PPH.
  • This case emphasizes the importance of recognizing and managing rectal perforation after PPH, even in low-incidence scenarios.