PMC5928289_01
Computed Tomography Scan Demonstrating Perianal Fistula/Scar Tissue and Fluid Filled Rectum.
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After a wide local excision of the cancer and a Hartmann's procedure with an end colostomy, the patient subsequently developed anal canal stenosis (Fig. 1).
Computed Tomography Scan Showing Tense Mucus Filled Rectum.
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A computed tomography scan of the abdomen and pelvis showed fluid accumulation adjacent to the anastomotic site (Fig. 2).
(a) Diagram of the intersphincteric Plane, Figure Adopted from Zeitels et al., 2 November 2016. (b) Mobilization of the Rectum in the Intersphincteric Plane, Figure Adopted from Zeitels et al., 2 November 2016. (c) Approximation of the External Sphincter Muscle After Intersphincteric Proctectomy, Figure Adopted from Zeitels et al., 2 November 2016.
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The levator ani and external sphincter muscles were closed with interrupted sutures and the small perineal wound was closed primarily (Fig. 3a-c).