RESUMO
A 43-year-old man with imperforate anus surgically corrected at birth presented with bleeding per rectum and constipation. On investigations, there was an adenocarcinoma at 2 cm from anal verge involving mid and lower rectum. He underwent abdominoperineal resection. During surgery, he was found to have a rectourethral fistula. The relationship between imperforate anus, rectourethral fistula and carcinoma of rectum is disclosed.
Assuntos
Adenocarcinoma/complicações , Anus Imperfurado/complicações , Fístula Retal/complicações , Neoplasias Retais/complicações , Doenças Uretrais/complicações , Fístula Urinária/complicações , Adenocarcinoma/terapia , Adulto , Anus Imperfurado/cirurgia , Humanos , Masculino , Fístula Retal/cirurgia , Neoplasias Retais/terapia , Doenças Uretrais/cirurgia , Fístula Urinária/cirurgiaRESUMO
Our study aims to review the literature on the management of pyogenic liver abscess, focusing on the choice of drainage. A case series of our experience with clinicopathological correlation is presented to highlight the indication and outcome of each modality of drainage. Intravenous antibiotic is the first line, and mainstay, of treatment. Drainage is necessary for large abscesses, equal to or larger than 5 cm in size, to facilitate resolution. While percutaneous drainage is appropriate as first-line surgical treatment in most cases, open surgical drainage is prudent in cases of rupture, multiloculation, associated biliary, or intra-abdominal pathology. Percutaneous drainage may help to optimize clinical condition prior to surgery. Nevertheless, in current good clinical practices, the choice of therapy needs to be individualized according to patient's clinical status and abscess factors. They are complementary in the management of liver abscesses.