Seminal Vesicle-Rectal Fistula Secondary to Anastomotic Leakage after Low Anterior Resection for Rectal Cancer: Report of A Case

Seiichi Kawasaki, Shuji Saito, Hiroyuki Hazama, Hiroyuki Tomioka, Shintaro Akamoto, Tatsuo Okumoto, Yusuke Kinugasa, Masayuki Ishii and Katsuhiko Uesaka*

Department of Colon and Rectal Surgery and Department of Hepato-Biliary-Pancreatic Surgery*, Shizuoka Cancer Center Hospital

We report a case of seminal vesicle and rectal fistula. A 52-year-old man undergonig low anterior resection (LAR) for rectal cancer was found histopathologically to have well differentiated tubular adenocarcinoma with subserosal invasion and regional lymph node metastasis. Although discharged on postoperative day (POD) 11, the man reported dysuria and fever on POD 15, and was diagnosed with urinary tract infection. Even after antibiotics, he developed melena, hematuria, and pneumaturia. He was diagnosed with seminal vesicle and rectal fistula secondary to anastomotic leakage in computed tomography and water-soluble contrast enema. Seven months after undergoing diverting loop colostomy, a water-soluble contrast enema showed that the fistula had disappeared, so the colostomy was closed. Seminal vesicle and rectal fistula secondary to anastomotic leakage after LAR is rare, but should be considered when the patient report post-LAR dysuria, pneumaturia, or testicular pain.

Key words
seminal vesicle and rectal fistula, anastomotic leakage, low anterior resection

Reprint requests
Seiichi Kawasaki Department of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital
1007 Shimonagakubo, Nagaizumi, Suntogun, 411-8777 JAPAN

Accepted
April 23, 2008

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