Rectovesical fistula and rectal anastomotic leak


This patient has a T4 rectal tumor with invasion of the posterior bladder wall at surgery.  A partial cystectomy was performed.

In the early post-operative stage, the following developed:

1.  A rectovesical fistula

2.  A rectal anastomotic leak with pre-sacral collection

Contrast was only injected via the suprapubic catheter so after contrast entered the rectum from the bladder through the fistula, it then leaked via the anastomotic breakdown into the pre-sacral space.

The patient returned to theater. Dense adhesions meant an end colostomy had to be performed.

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