PMC6630029_01
CT scan of an anastomotic leak and infection of the soft tissue in the right lower abdomen.
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On the 8th postoperative day, severe necrotic tissue infection in the right groin and a presacral anastomotic leak were confirmed (Fig. 1).
Granulating tissue after the first session of EVAC.
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Endoscopy showed a 3 cm wide anastomotic dehiscence on the ventrolateral margin with a 5 cm long cavity and pelvic necrotic tissue (Fig. 2).
Skin necrosis of the right groin and femoral region.
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Necrectomy of necrotic skin and soft tissue extending to right lower pelvis was carried out and drained with subsequently proven Enterococcus and Pseudomonas infection (Fig. 3).
Healed defect 3 months after the termination of EVAC therapy.
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Colonoscopy 3 months after surgery showed a healed anastomosis without remanent cavity, fistula or stenosis (Fig. 4).