1Kenza Benjelloun Touimi, 2Rihane souha, 3El Wassi Anass, 4Hajri Amal, 5Erguibi Driss, 6Boufettal Rachid, 7Jai Rifki Saad, 8Chehab Farid
1,2,3,4,5,6,7,8Department of digestive cancer surgery and liver transplantation Ibn Rochd University Hospital, Hassan II Univeversity, Casablanca
ABSTRACT
We present the case of a 72-year-old diabetic and hypertensive female patient who underwent colorectal resection for adenocarcinoma, with mechanical anastomosis and prophylactic pre-anastomotic drainage.
The postoperative course was marked by diabetic ketoacidosis, thrombocytopenia, and a deterioration of the general condition.
On the second postoperative day, the drain yielded blackish fluid, accompanied by fever, abdominal distension, and a significant increase in CRP and procalcitonin levels.
A CT scan of the abdomen and pelvis revealed peritoneal infiltration, a large amount of pneumoperitoneum, peri-anastomotic air bubbles, and an intra-luminal drain, prompting urgent surgical re-intervention.
Exploration confirmed an anastomotic leak with the presence of the drain inside the anastomosis. A Hartmann’s colostomy was performed.
This case highlights the controversial role of prophylactic drainage, which may contribute to the occurrence of anastomotic fistulas.
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