Rektovesikal fistel som komplikation i forbindelse med endoskopisk vakuumbehandling af kronisk præsakral kavitet

A 66-year-old male who underwent Hartmann's operation for rectal cancer developed a pelvic abscess treated with late onset endoscopic vacuum (endo-VAC). He developed a fistula from the abscess to the bladder. The literature does not support prolonged or late onset endo-VAC to treat chronic pelvic abscesses. There is only evidence for early treatment of the presacral abscess. To prevent fistula formation during endo-VAC, care should be taken if the abscess-cavity is close to the bladder or the sponge is in direct contact with other bowel segments. Magnetic resonance imaging with contrast enema can show the relation.