Indah Jamtani, Adianto Nugroho*, Rofi Y Saunar, Aditomo Widarso and Taslim Poniman

Digestive Division, Department of Surgery, Fatmawati Central General Hospital, Indonesia

*Corresponding Author: Adianto Nugroho, Digestive Division, Department of Surgery, Fatmawati Central General Hospital, Indonesia.

Received: May 09, 2022; Published: June 15, 2022

Abstract

Anal stenosis occurs in 1.5-3.8% of post-hemorrhoidectomy cases. Post-hemorrhoidectomy anal stenosis accompanied by acute bowel obstruction is extremely rare. We present a 55-year-old lady with acute bowel obstruction after undergoing hemorrhoidectomy procedure. Examination under anesthesia revealed a macerated perianal area with no detectable anoderm layer, and the anal mucosa was adhered cranially, causing an apparent narrowing of the anal canal. We decided on a staged repair. Debridement of the perianal area was performed, and sutures from the overzealous hemorrhoidectomy were removed. We left the wound open for secondary healing with a diverting sigmoid colostomy. Anal stricture developed as the wound healed, and a rhomboid flap anoplasty was done six months after the first surgery. Routine anal dilatation and biofeedback were performed before closure of the ostomy three months after anal reconstruction. Although relatively a low-risk procedure, hemorrhoidectomy could cause debilitating complications. Anal stenosis is a devastating, life-altering complication of an overzealous hemorrhoidectomy.

Keywords: Post-Hemorrhoidectomy; Anal Stenosis; Acute Bowel Obstruction

References

1. Mitchem JB and Wise PE. “Anal stenosis after hemorrhoidectomy: avoidance and management”. In: Gastrointestinal Surgery. New York: Springer Scuence + Business Media (2015): 461-469.
2. Asfar S. “Anoplasty for Post-hemorrhoidectomy Low Anal Stenosis: A New Technique”. World Journal of Surgery 9 (2018): 3015-3020.
3. Eu KW., et al. “Anal stricture following haemorrhoidectomy: early diagnosis and treatment”. ANZ Journal of Surgery 2 (1995): 101-103.
4. , et al. “Repair of anal stenosis using a prolapse and hemorrhoids (PPH) stapler procedure: A case report with excellent results”. International Journal of Surgery Open 27 (2020): 43-46.
5. Gallo G., et al. “A tailored rhomboid mucocutaneous advancement flap to treat anal stenosis”. Colorectal Disease 10 (2020): 1388-1395.
6. Liberman H and Thorson AG. “How I do it. Anal stenosis”. The American Journal of Surgery 4 (2000): 325-329.
7. Cipriani S and Pescatori M. “Acute rectal obstruction after PPH stapled haemorrhoidectomy”. Colorectal Disease 5 (2002): 367-370.
8. Brisinda G., et al. “Surgical treatment of anal stenosis”. World Journal of Gastroenterology 16 (2009): 1921-1928.
9. Duieb Z., et al. “Anal stenosis: use of an algorithm to provide a tension-free anoplasty”. ANZ Journal of Surgery 5 (2010): 337-340.
10.  

Citation

Citation: Adianto Nugroho., et al. “The Fate of Post-Hemorrhoidectomy Anal Stenosis Presenting as Acute Bowel Obstruction; A Case Report". Acta Scientific Gastrointestinal Disorders 5.7 (2022): 49-53.

Copyright

Copyright: © 2022 Adianto Nugroho., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.