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. 2015:6C:237-40.
doi: 10.1016/j.ijscr.2014.10.010. Epub 2014 Dec 12.

Laparoscopic approach in a case of retroperitoneal and mesorectal haematoma following STARR procedure

Guido Cerullo  1 , Diletta Cassini  2 , Jacopo Martellucci  3 , Gianandrea Baldazzi  2
Affiliations

Laparoscopic approach in a case of retroperitoneal and mesorectal haematoma following STARR procedure

Guido Cerullo et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Stapled transanal rectal resection (STARR) is a widely accepted procedure for treatment of obstructed defecation syndrome.

Presentation of case: We analyzed major bleeding following STARR and exposed our experience regarding its conservative management with particular attention about diagnostic and therapeutic aspects.

Discussion: A case by case discussion should be carried out and treatments should be driven by the features and the progression of the haematoma with regards to size, inflammatory signs or severe rectal obstruction.

Conclusion: If a second surgical time and exploration is considered, laparoscopy should be an effective choice while laparotomy, stoma or rectal resection should be considered in those cases with strong suspicious of peritonitis and pelvic abscess.

Keywords: Major bleeding; Obstructed defecation syndrome; STARR.

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Figures

Figs. 1 and 2
Figs. 1 and 2
Abdominal CT scan showed a mesorectal haematoma (10 × 8 × 8 cm) with an active spreading of contrast (arrow) and rectal lumen completely displaced (*).
Fig. 3
Fig. 3
Laparoscopic exploration showing the distribution of the haematoma.
See this image and copyright information in PMC

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