Case reportsEarly anastomotic stricture occurring after colectomy that responded well to Transanal decompression and local steroid therapy: A case report

- Very few studies have reported anastomotic strictures occurring soon after colectomy. No established treatment is available.
- We describe our experience with a patient who had bowel obstruction due to an anastomotic stricture 12 days after colectomy.
- Steroid local therapy has been reported to be effective when combined with gastrointestinal endoscopic treatment. However, few studies have reported on anastomotic strictures of the colorectum.
- Transanal decompression therapy and local steroid therapy promptly improved symptoms in a patient with an anastomotic stricture of the colon.
- Transanal decompression therapy combined with local steroid therapy may improve anastomotic strictures occurring soon after colectomy.

IntroductionAnastomotic strictures occurring after colectomy are a most challenging postoperative complication for gastroenterological surgeons. Reports documenting anastomotic strictures developing in the early postoperative phase are scant, and no established treatment is available.Presentation of caseA 78-year-old man who had undergone a laparoscopic left hemicolectomy for lower colon cancer presented on postoperative day 12 because of abdominal pain and no bowel movement. Endoluminal decompression was performed with a transanal decompression tube, and local steroid treatment was administered by concurrent intralesional steroid injection (ILe-SI) and intraluminal steroid instillation (ILu- SI). The anastomotic stricture promptly improved. The patient recovered uneventfully, with no recurrence of anastomotic stricture.DiscussionA transanal decompression tube should be inserted and placed in a cautious manner within a short period of time. ILe-SI in the large intestine requires an understanding of potential adverse events and complications, as well as fully informed consent from the patient. ILu-SI has been reported to be an effective treatment for the management of strictures in various regions. To the best of our knowledge, however, this is the first report to document the treatment of an anastomotic stricture of the colorectum by ILu-SI.ConclusionTransanal decompression therapy combined with local steroid local treatment might promptly improve anastomotic strictures occurring after colectomy.