Case Report: A case of perirectal abscess complicated with rectal necrosis

Area of Science:

• Gastroenterology and Surgical Innovation
• Vascular Surgery
• Colorectal Surgery

Background:

• Rectal necrosis, a severe form of ischemic proctitis, is uncommon due to the rectum's rich collateral circulation, affecting 2%-5% of ischemic colitis cases.
• Etiologies include acute vascular occlusion, systemic vascular diseases, hypoperfusion states, radiotherapy, vasculitis, and mesenteric venous myointimal hyperplasia.

Observation:

• A rare case of perirectal abscess complicated by rectal necrosis was managed at the Anorectal Surgery Department of Bao'an Traditional Chinese Medicine Hospital.
• The patient presented with a perirectal abscess that progressed to rectal necrosis.

Findings:

• A multidisciplinary team approach was employed, involving a one-stage incision and drainage for the rectal abscess.
• Subsequent management included sigmoid colostomy and a two-stage reversal of the colostomy.

Implications:

• This case demonstrates the successful surgical management of a rare complication of rectal necrosis secondary to a perirectal abscess.
• Favorable outcomes were achieved after a 6-month follow-up, underscoring the efficacy of collaborative, staged surgical interventions.