Anastomotic Leak of Colon Successfully Treated With Double Pig Tail Stent Placed Endoscopically: Literature Review and Case Report.

Abstract

Anastomotic leakage after colorectal surgery is a serious complication , leading to higher morbidity and mortality, permanent stoma formation, and cancer recurrence. Management of anastomotic leaks is patient-specific and surgical management is dictated by the degree of contamination, inflammation, and patient risk factors. Internal drainage with double pigtail stents - initially used for managing leaks after bariatric surgery - has recently been applied to anastomotic leaks following resection of colorectal malignancies. Herein we report the case of a 65-year-old male with a history of sigmoid resection and colosostomy with subsequent ostomy takedown who presented for follow-up. Imaging at this visit showed concern for possible anastomotic leak at the ostomy takedown site. Further endoscopic investigation revealed a small area of anastomotic dehiscence which was therapeutically addressed with stent placement. The patient later presented with concerns of stent migration confirmed with imaging. A larger caliber secondary stent was then successfully placed, and placement and therapeutic effect were confirmed at follow-up. This paper aims to highlight the role of endoscopic management of colorectal anastomotic leak.