Seminal Vesicle-Rectal Fistula Secondary to Anastomotic Leakage After Low Anterior Resection for Rectal Cancer: A Case Report and Brief Literature Review

We report a case of a patient with seminal vesicle-rectal fistula, an extremely rare complication of low anterior resection of the rectum. A 53-year-old man with rectal adenocarcinoma underwent low anterior resection in our hospital. The patient experienced diarrhea, pneumaturia, and low-grade fever on postoperative day 13. A computed tomography scan showed emphysema in the right seminal vesicle. We concluded that anastomotic leakage induced a seminal vesicle-rectal fistula. The patient underwent conservative therapy with total parenteral nutrition and oral intake of metronidazole. Diarrhea and pneumaturia rapidly improved after metronidazole administration and the patient was successfully cured without invasive therapy such as colostomy or surgical drainage. A seminal vesicle-rectal fistula is a rare complication of low anterior resection, and therapeutic strategies for this condition remain elusive. Our report provides valuable information on the successful conservative treatment of a secondary seminal vesicle-rectal fistula that developed after low anterior resection of the rectum in a patient.Key words: Seminal vesicle-rectal fistula, low anterior resection, rectal cancerSeminal vesicle-rectal fistula is a rarely encountered complication in patients. The reported causes of this condition are Crohn''s disease,^1,2 diverticulitis,^3–6 operative complications of the prostate,^7,8 direct invasion of rectal cancer,⁹ congenital anomalies,¹⁰ iatrogenic perforation by transrectal aspiration or seminal vesicle abcess,¹¹ secondary vesiculitis,¹² and anastomotic leakage after low anterior resection (LAR) of the rectum.^2,13–18 We could find only 9 reported cases of seminal vesicle-rectal fistula after LAR in the PubMed database.Here, we present a case of a seminal vesicle-rectal fistula that developed after LAR in a patient and review the clinical manifestation, radiographic findings, and treatment procedure for this condition.