ABSTRACT
A previously unreported complication of low anterior resection of the rectum, seminal vesicle-rectal fistula, was encountered one month after surgery in an elderly patient with adenocarcinoma of the midrectum. Antibiotic-induced colitis in the immediate postoperative period led to anastomotic leakage with abscess formation and ensuing fistulization to the surgically denuded right seminal vesicle. Pneumaturia, bacteriuria, and right testicular pain were treated by cutaneous vasostomy and antimicrobial therapy. Despite recurrent low-grade urinary sepsis controlled by alternating courses of various antimicrobials, and radiation therapy for local tumor recurrence, the patient remained reasonably healthy until his death two years later due to stroke associated with cerebral metastases.
Subject(s)
Adenocarcinoma/surgery , Fistula/etiology , Postoperative Complications , Rectal Fistula/etiology , Rectal Neoplasms/surgery , Seminal Vesicles , Aged , Genital Diseases, Male/etiology , Humans , Male , Methods , Rectum/surgeryABSTRACT
We report a case of reno-colic fistula with abscess formation, which was treated by staged surgical procedures. One must be wary of automatically implicating the colon as the primary source of the problem when the colon and adjacent organs are involved in an inflammatory process. In cases involving the superior segments of the colon, the kidney or pancreas may be the source of the fistula.
