Endoscopic management of colorectal anastomotic leakage complicated with pelvic abscess : endoscopic vacuum therapy a new strategy ?

A 56-years old woman underwent laparoscopic anterior resection of the rectum with lymph node dissection and colorectal anastomosis for an adenocarcinoma. One month later, she presented an anastomotic leakage complicated with a presacral abscess and a rectovaginal fistula. The collection was drained endoscopically with double pigtail stents associated with placement of an EndoSponge. The endosponge was connected to an external vacuum collector. The EndoSponge was changed every 3 to 4 days. At day 26, the leakage with the collection were also completely closed. Control at 2 months showed a normal colorectal anastomosis without recurrence of pelvic collection or recto-vaginal fistula.