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What to do with a patient with a history of oncological rectal resection and asymptomatic pelvic collection after an ileostomy reversal?
Posted in Debates on 3 May 2016

A 60-year-old man with a previous oncological history of a locally advanced distal T3c rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and posterior TaTME in November 2014. During the postoperative period, the patient had a presacral infected hematoma/abscess with suspected leakage due to the presence of air inside the abscess, with no evidence of leakage in complementary studies. He was treated with antibiotics with satisfactory evolution. After a correct contrast enema study the ileostomy was reverted. In the three-month follow up, a presacral collection was found in a CT scan (FIG 1). The patient is asymptomatic, with no fever, pain or purulent transanal discharge. What would YOU do now?

Presacral-collection
FIG 1. Presacral-collection

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