Occluded coloanal anastomosis: transrectal US-guided balloon dilation

Balloon dilation is a well-described, nonoperative, alternative treatment for postoperative strictures of the colon and rectum. This procedure may not be technically feasible when an occluded lumen prevents passage of a guide wire across the obstruction. The authors describe the use of transrectal ultrasound guidance to initially pass a needle across an occlusive web at the coloanal anastomosis after proctosigmoidectomy. This allowed placement of a guide wire across the occlusion and subsequent successful balloon dilation.