[Endoscopic vacuum-assisted treatment of a large supralevator abscess]

Supralevatory abscesses (SA) are rare entities complicating diagnosis and treatment. We present the case report of a 64-year-old male with a large SA and a low transsphincteric fistula requiring surgery. Due to comorbidities and the size of the SA an endoscopic vacuum therapy (EVC) was placed for adequate drainage with good results at the six weeks follow-up. EVC is minimally invasive with continual drainage, it promotes granulation and reduces the cavity. EVC could be a new method of treating SA in multimorbid patients. However, these patients should be chosen by an experienced surgeon.