Abstract
RATIONALE: There have been no reports of delayed anastomotic leakage of the ileum caused by compression of an intra-abdominal hematoma due to postoperative bleeding after ileostomy closure. PATIENT CONCERNS: We report the case of a 44-year-old man with delayed anastomotic leakage after ileostomy closure caused by the compression of an intra-abdominal hematoma that healed quickly after fluoroscopic balloon dilatation of the bowel stenosis area. DIAGNOSES: Postoperative bleeding and hemorrhagic shock occurred on postoperative day 1 after ileostomy closure. Vital signs stabilized after blood transfusion, and computerized tomography-guided drainage was successfully performed to reduce the hematoma volume. However, residual hematoma compressed the ileum on the anal side of the anastomosis, leading to delayed anastomotic leakage. INTERVENTIONS/OUTCOMES: Fluoroscopic balloon dilation of the stenotic area through the drain was successfully performed, and the anastomotic leakage healed quickly. LESSONS: In cases of small intestinal anastomotic leakage after postoperative bleeding, compression of the intestinal tract due to a hematoma should be considered. Fluoroscopic balloon dilation through a drain is an effective procedure.