Anorectal manometry after rectal surgery: a case report with rectal bleeding and perforation

Area of Science:

• Gastroenterology
• Surgical Procedures
• Diagnostic Techniques

Background:

• Anorectal manometry (ARM) assesses sensorimotor function in conditions like constipation and fecal incontinence.
• ARM is applicable to both adult and pediatric populations.
• This case highlights ARM following rectal resection for prolapse, complicated by bleeding and perforation.

Observation:

• A 58-year-old female with hypertension and prior cerebral infarction underwent proctocolectomy for rectal prolapse.
• Post-surgery, she developed chronic constipation, leading to ARM 11 months later.
• Two hours post-ARM, she experienced rectal bleeding, necessitating hospitalization and surgical intervention for rupture and perforation.

Findings:

• The patient developed rectal rupture and perforation during or shortly after anorectal manometry.
• Timely and aggressive surgical management was required to address the complications.
• The patient recovered fully after 30 days of hospitalization and surgical treatment.

Implications:

• Anorectal manometry should be performed with caution in patients with a history of rectal surgery, especially those with comorbidities.
• Prompt surgical intervention is critical for managing rectal bleeding and perforation during ARM.
• Developing systematic management plans and continuous experience summarization are essential to improve ARM safety and reduce complications.