We present a rare case of complicated sigmoid diverticulitis presenting as a peri-anal abscess from an extra-sphincteric fistulous tract. This presentation of a colocutaneous peri-anal abscess is extremely rare, with only a handful of cases described in the literature. Most are managed with an open sigmoid colectomy, however, this case was successfully managed laparoscopically. It highlights the need to consider extra-levator causes of peri-anal abscess, such as pelvic sepsis causing fistulating disease, and to consider early magnetic resonance imaging if there is clinical suspicion of underlying pathology. It also demonstrates that a safe and potentially less morbid outcome is possible via laparoscopic approach when compared to traditional open surgical approach.
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http://dx.doi.org/10.1093/jscr/rjab483 | DOI Listing |
Cureus
July 2024
General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Fistula-in-ano and anorectal abscesses are commonly encountered in surgical departments, but their extension into the retroperitoneum and pelvis to form an extensive collection is rare. Here, we present the case of a 66-year-old diabetic male who presented with lower abdominal pain and fever for a day, with signs of sepsis. He had a simple fistula in the perianal region for the past 15 years.
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April 2024
General Surgery, BronxCare Health System, New York, USA.
Deep-tissue extension of perianal and perirectal abscesses, while rare, requires timely diagnosis and emergent surgical intervention to prevent serious secondary complications. This report evaluates a case of intra-abdominal and extraperitoneal extension of a persistent perirectal abscess that required comprehensive irrigation, drainage, and debridement of multiple abscess-associated cavities. This report follows the case of a 24-year-old African-American female presenting to the ED with mild fevers, nausea, abdominal distension, and lower abdominal pain following a persistent perirectal abscess that had not resolved following conservative outpatient antibiotic management one week prior.
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January 2024
General Practice, Gandhi Medical College and Hospital, Hyderabad, IND.
Background Anorectal fistulas are chronic inflammations of peri-anal tissues that form a connection between the perineal skin and the anal canal. Accurate preoperative evaluation of the main fistula's trajectory and pelvic tissues is essential for effective surgical treatment of anal fistulas. The inability to detect concealed lesions may result in the recurrence of fistulas and the conversion of a simple fistula into a complex fistula.
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November 2023
General Surgery, Prince Sultan Military Medical City, Riyadh, SAU.
J Glob Antimicrob Resist
September 2023
Institute for Medical Microbiology, Virology and Hygiene, University Medical Center, Hamburg, Germany. Electronic address:
Here we report the in vivo development of cefiderocol resistance within 11 days after therapy initiation in a critically ill patient with bloodstream infection, infection of peri-anal fistula, and pneumonia caused by a VIM-2 harbouring, carbapenem-resistant Pseudomonas aeruginosa. Compared to a cefiderocol-naïve P. aeruginosa blood culture isolate, agar diffusion susceptibility testing found a reduced cefiderocol inhibition zone diameter in a P.
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