Operative Management and Outcome of Idiopathic Rectal Necrosis in an Octogenarian.

Autor:	Baljepally V; Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA., McBride ME; Department of Surgery, East Tennessee State University, Johnson City, TN, USA., Smith L; Department of Surgery, East Tennessee State University, Johnson City, TN, USA., Burns JB; Department of Surgery, East Tennessee State University, Johnson City, TN, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Aug; Vol. 90 (8), pp. 2130-2131. Date of Electronic Publication: 2024 Apr 03.
DOI:	10.1177/00031348241241690
Abstrakt:	Idiopathic acute rectal necrosis (IARN) is a rare condition due to a robust rectal blood supply. This report describes an 83-year-old man presenting with septic shock due to distal sigmoid and complete rectal necrosis with perforation. He underwent emergent exploratory laparotomy, sigmoid and proximal rectum resection, and end sigmoid colostomy creation with delayed distal rectal evaluation. Bedside proctoscopy revealed pale, viable-appearing distal rectal mucosa on postoperative day 3. The patient had a protracted, complicated hospital stay but required no further operative intervention. Subsequent colostomy reversal was done 8 months postoperatively, and the patient did well and has been discharged with normal gastrointestinal function. Our successful conservative operative management of IARN deviates from previously described management in the literature which is emergent abdominoperineal resection. This conservative surgical strategy appears to have contributed to the patient's positive outcomes, highlighting the importance of considering a similar approach for future IARN cases. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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