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Complete Rectal Anastomotic Occlusion That Spontaneously Recanalized, Allowing for Unusual Endoscopic Treatment with
Tal Weiss1,2, Mark Kirshon1, Veacheslav Zilbermints1,3
1Department of General Surgery, Hillel Yaffe Medical Center, Affiliated with The Rapaport School of Medicine, Technion, Haifa, Israel.
Introduction:
Complete anastomotic occlusion following rectal surgery is a rare and challenging complication. While surgical revision remains the standard treatment, it is associated with significant morbidity. Recently, novel endoscopic techniques have emerged as minimally invasive alternatives.
Case Presentation:
We report the case of a 64-year-old patient who developed complete rectal anastomotic occlusion after low anterior resection and declined further surgery. Five months later, spontaneous recanalization was observed, allowing for successful endoscopic treatment using a lumen-apposing metal stent (LAMS). The stent was later removed, and ileostomy reversal was completed successfully.
Conclusion:
Watchful surveillance for spontaneous recanalization may offer a safe opportunity for endoscopic intervention in selected high-risk, diverted patients with complete rectal anastomotic occlusion. LAMS may serve as an effective alternative to fully covered self-expandable metal stents in cases of severe strictures.
