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Case Reports in Surgery
Volume 2017, Article ID 2062157, 3 pages
https://doi.org/10.1155/2017/2062157
Case Report

Treatment of Complete Anal Stricture after Diverting Colostomy for Fournier’s Gangrene

1Department of Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center (Noguchi Memorial Institution Hospital), Urayasu, Japan
2Department of Surgery, Uwamachi General Hospital, Yokosuka, Japan
3Department of Surgery, Jichi Medical University, Tochigi, Japan

Correspondence should be addressed to Kenji Okumura; moc.liamg@026ukoijnek

Received 21 July 2016; Accepted 5 January 2017; Published 31 January 2017

Academic Editor: Imran Hassan

Copyright © 2017 Kenji Okumura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier’s gangrene and treated with debridement and diverting colostomy. He needed temporary continuous renal replacement therapy and was discharged on postoperative day 39. After four months, severe anal stenosis was found on physical examination, and total colonoscopy showed a complete anal stricture. The patient was brought to the operating room and underwent colostomy closure and anoplasty. He recovered without any complications. Conclusion. We present a first patient with a complete anal stricture after diverting colostomy treated with anoplasty and stoma closure. This case reminds us of the assessment of distal bowel conduit and might suggest that anoplasty might be considered in the success of the colostomy closure.