Abstract
Post-surgical colorectal anastomoses are complicated by strictures in 2-5.8% of cases. However, complete fibrotic occlusion of the anastomosis is exceedingly rare, and management is not well established. Surgical revision is often recommended, but can be technically difficult. Endoscopic intervention is limited to case reports, including the use of biliary sphincterotomes or electrosurgical knives followed by balloon dilation for luminal recanalization. However, puncture of the blind end of the anastomosis may lead to perforation as well as injury to surrounding vascular structures. We describe the management of a completely obliterated colorectal anastomosis utilizing an endoscopic ultrasound (EUS)-guided rendezvous procedure to restore luminal continuity. A 73-year-old man was diagnosed with a T4N0M0 colorectal cancer. He underwent a low anterior resection with a left coloproctostomy and diverting loop ileostomy. Prior to ileostomy takedown, a barium enema was obtained which showed no passage of contrast beyond the proximal rectum. A flexible sigmoidoscopy demonstrated complete occlusion with scarring of the colorectal anastomosis. Biopsies were negative for malignancy. The patient was referred to our institution for consideration of endoscopic intervention.
Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
