Multivisceral resection for colonic splenic flexure malakoplakia: a case report of a minimally invasive approach
10.3393/ac.2021.00178.0025
- Author:
Andrés Ramiro Lanza DÍAZ
1
;
Santiago Gallardo PEZET
;
Osvaldo Soto GONZÁLEZ
;
Montserrat Guraieb TRUEBA
;
Ivan Azael Martínez ALONSO
;
Mario Alberto López RAMIREZ
Author Information
1. Division of Colorectal Surgery, Surgery Department, Hospital Central Militar, Secretaría de la Defensa Nacional, Mexico City, Mexico
- Publication Type:Case Report
- From:Annals of Coloproctology
2023;39(2):178-182
- CountryRepublic of Korea
- Language:English
-
Abstract:
Malakoplakia is a rare granulomatous inflammatory disorder. Its diagnosis depends on histopathological findings; however, high-quality literature regarding proper medical/surgical treatment is lacking. A 38-year-old diabetic female patient was admitted to the emergency room with a history of lower gastrointestinal hemorrhage. Colonoscopy revealed a lesion in the descending colon, and abdominal computed tomography revealed a splenic flexure mass involving the lower pole of the spleen and upper pole of the left kidney. Biopsies confirmed the diagnosis of malakoplakia. After completing antibiotic treatment, a restaging computed tomography revealed a discrete mass increase; hence, the patient underwent laparoscopic en bloc colectomy and partial nephrectomy. Postoperatively, the patient developed a pancreatic fistula, which was successfully treated with percutaneous drainage and antibiotics. The presence of pathognomonic Michaelis-Gutmann inclusions on histopathology is frequently reported as the key to diagnosing malakoplakia. Herein, we present a successful, minimally invasive surgical treatment for colonic malakoplakia.
