A 55-year-old man undergoes a low anterior resection without diverting ileostomy for an T2N0M0 rectal cancer with anastomosis 5 cm from the anal verge. On postoperative day 10, he presents to the emergency department with low abdominal pain and bloating, decreased bowel function, urinary hesitancy, and low-grade fever. On examination, his heart rate is 90, blood pressure is 110/55 mmHg, and temperature is 100.5 °C. He has some localized low abdominal tenderness. His white blood cell count is 15. Computed tomography (CT) of the abdomen and pelvis with oral, intravenous (IV), and rectal contrast shows a 5-cm perianastomotic abscess with some stranding but no free air. What is the best next step in the management of this patient?
There's more to see -- the rest of this topic is available only to subscribers.