Sepsis after the Altemeier procedure: A case report
Abstract
Rationale: Anastomotic leakage represents the most critical complication following the Altemeier procedure. However, sepsis resulting from anastomotic leakage has been rarely reported in the literature.
Patient concerns: A 53-year-old male with chronic obstructive pulmonary disease and rectal prolapse underwent the Altemeier procedure. On postoperative day 4, he developed sepsis secondary to anastomotic leakage.
Diagnoses: The patient's condition deteriorated after the Altemeier procedure, presenting with sepsis, anastomotic leakage, presacral infection, and acute exacerbation of chronic obstructive pulmonary disease.
Interventions: Terminal ileostomy was performed, and a self-designed double-lumen irrigation-drainage catheter was placed at the anal anastomotic site for irrigation and drainage to control the source of infection. Concurrent intravenous antimicrobial therapy with meropenem and levofloxacin was administered.
Outcomes: 22 days after the terminal ileostomy procedure, procalcitonin and C-reactive protein levels normalized, and the patient was discharged. At the 4-month follow-up, colonoscopy revealed complete healing of the anastomosis, and successful ileostomy reversal surgery was subsequently performed.
Lessons: For patients with rectal prolapse who have other comorbid infections or malnutrition, thorough preoperative assessment before the Altemeier procedure is crucial for preventing severe anastomotic leakage.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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