Supralevator abscess: New treatment for an uncommon aetiology: Case report
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.10/2369 |
Resumo: | Abstract INTRODUCTION: Supralevator abscess is the least common type of anorectal abscess. Its diagnosis can be hard and treatment difficult. PRESENTATION OF THE CASE: A 48-year-old men was diagnosed in the emergency department with a supralevantor abscess. Under general anaesthesia, the abscess drainage was accomplished after removal of a fish bone, who was perforating the rectum. Due to persistent rectal purulent discharge, a pelvic Magnetic Resonance (MRI) was performed: a supralevator abscess adjacent to the internal obturator muscle and an inter-sphincteric fistulae from the inferior margin of this collection were identified. A Pezzer® drain was placed through the fistula tract. After radiological resolution, under general anaesthesia, the patient was submitted to extraction of the drain and marsupialization of the path left using an ENDO GIA®. At two year follow up he remained asymptomatic. DISCUSSION: Despite of the abscess aetiology, the principles of treatment are the same: good radiological characterization and proper drainage. An adequate radiological characterization is important to avoid iatrogenic creation of a complex fistulae. CONCLUSION: If a supralevator abscess diagnosis is made, fistulae trajectory should be studied. If no clear internal opening is evident, a pelvic MRI should be done followed by drainage of the abscess. After resolution the drain should be taken off and marsupialization with ENDO GIA® should be performed. |
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Supralevator abscess: New treatment for an uncommon aetiology: Case reportAbscessAnus diseasesRectal fistulaMagnetic resonance imagingAbstract INTRODUCTION: Supralevator abscess is the least common type of anorectal abscess. Its diagnosis can be hard and treatment difficult. PRESENTATION OF THE CASE: A 48-year-old men was diagnosed in the emergency department with a supralevantor abscess. Under general anaesthesia, the abscess drainage was accomplished after removal of a fish bone, who was perforating the rectum. Due to persistent rectal purulent discharge, a pelvic Magnetic Resonance (MRI) was performed: a supralevator abscess adjacent to the internal obturator muscle and an inter-sphincteric fistulae from the inferior margin of this collection were identified. A Pezzer® drain was placed through the fistula tract. After radiological resolution, under general anaesthesia, the patient was submitted to extraction of the drain and marsupialization of the path left using an ENDO GIA®. At two year follow up he remained asymptomatic. DISCUSSION: Despite of the abscess aetiology, the principles of treatment are the same: good radiological characterization and proper drainage. An adequate radiological characterization is important to avoid iatrogenic creation of a complex fistulae. CONCLUSION: If a supralevator abscess diagnosis is made, fistulae trajectory should be studied. If no clear internal opening is evident, a pelvic MRI should be done followed by drainage of the abscess. After resolution the drain should be taken off and marsupialization with ENDO GIA® should be performed.ElsevierRepositório do Hospital Prof. Doutor Fernando FonsecaAparício, DJLeichsenring, CSobrinho, CPignatelli, NGeraldes, VNunes, V2019-12-20T14:26:07Z2019-01-01T00:00:00Z2019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.10/2369engInt J Surg Case Rep. 2019;59:128-131.2210-261210.1016/j.ijscr.2019.05.016info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-20T15:53:03Zoai:repositorio.hff.min-saude.pt:10400.10/2369Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:53:18.712195Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Supralevator abscess: New treatment for an uncommon aetiology: Case report |
title |
Supralevator abscess: New treatment for an uncommon aetiology: Case report |
spellingShingle |
Supralevator abscess: New treatment for an uncommon aetiology: Case report Aparício, DJ Abscess Anus diseases Rectal fistula Magnetic resonance imaging |
title_short |
Supralevator abscess: New treatment for an uncommon aetiology: Case report |
title_full |
Supralevator abscess: New treatment for an uncommon aetiology: Case report |
title_fullStr |
Supralevator abscess: New treatment for an uncommon aetiology: Case report |
title_full_unstemmed |
Supralevator abscess: New treatment for an uncommon aetiology: Case report |
title_sort |
Supralevator abscess: New treatment for an uncommon aetiology: Case report |
author |
Aparício, DJ |
author_facet |
Aparício, DJ Leichsenring, C Sobrinho, C Pignatelli, N Geraldes, V Nunes, V |
author_role |
author |
author2 |
Leichsenring, C Sobrinho, C Pignatelli, N Geraldes, V Nunes, V |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Hospital Prof. Doutor Fernando Fonseca |
dc.contributor.author.fl_str_mv |
Aparício, DJ Leichsenring, C Sobrinho, C Pignatelli, N Geraldes, V Nunes, V |
dc.subject.por.fl_str_mv |
Abscess Anus diseases Rectal fistula Magnetic resonance imaging |
topic |
Abscess Anus diseases Rectal fistula Magnetic resonance imaging |
description |
Abstract INTRODUCTION: Supralevator abscess is the least common type of anorectal abscess. Its diagnosis can be hard and treatment difficult. PRESENTATION OF THE CASE: A 48-year-old men was diagnosed in the emergency department with a supralevantor abscess. Under general anaesthesia, the abscess drainage was accomplished after removal of a fish bone, who was perforating the rectum. Due to persistent rectal purulent discharge, a pelvic Magnetic Resonance (MRI) was performed: a supralevator abscess adjacent to the internal obturator muscle and an inter-sphincteric fistulae from the inferior margin of this collection were identified. A Pezzer® drain was placed through the fistula tract. After radiological resolution, under general anaesthesia, the patient was submitted to extraction of the drain and marsupialization of the path left using an ENDO GIA®. At two year follow up he remained asymptomatic. DISCUSSION: Despite of the abscess aetiology, the principles of treatment are the same: good radiological characterization and proper drainage. An adequate radiological characterization is important to avoid iatrogenic creation of a complex fistulae. CONCLUSION: If a supralevator abscess diagnosis is made, fistulae trajectory should be studied. If no clear internal opening is evident, a pelvic MRI should be done followed by drainage of the abscess. After resolution the drain should be taken off and marsupialization with ENDO GIA® should be performed. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-12-20T14:26:07Z 2019-01-01T00:00:00Z 2019-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.10/2369 |
url |
http://hdl.handle.net/10400.10/2369 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Int J Surg Case Rep. 2019;59:128-131. 2210-2612 10.1016/j.ijscr.2019.05.016 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799130400512016384 |