Sepsis after the Altemeier procedure: A case report.

Area of Science:

• Gastroenterology
• Surgical Complications
• Infectious Disease

Background:

• Anastomotic leakage is a critical complication of the Altemeier procedure.
• Sepsis secondary to anastomotic leakage is infrequently reported.

Purpose of the Study:

• To report a rare case of sepsis resulting from anastomotic leakage after the Altemeier procedure.
• To highlight the management of severe sepsis and anastomotic leakage in a patient with rectal prolapse and comorbidities.

Main Methods:

• A patient with rectal prolapse underwent the Altemeier procedure and subsequently developed sepsis and anastomotic leakage.
• Management involved terminal ileostomy, irrigation-drainage catheter placement, and broad-spectrum antibiotics (meropenem and levofloxacin).

Main Results:

• The patient's sepsis and infection markers (procalcitonin, C-reactive protein) resolved within 22 days.
• Complete anastomotic healing was confirmed by colonoscopy at 4 months, allowing for successful ileostomy reversal.

Conclusions:

• Thorough preoperative assessment is vital for patients with rectal prolapse and comorbidities to prevent severe anastomotic leakage.
• Aggressive source control and antimicrobial therapy are crucial for managing sepsis post-Altemeier procedure.