Colorectal perforation following anorectal manometry in a patient with anal stenosis post rectal prolapse repair: a rare complication
Bibliographic record
Abstract
Anorectal manometry (ARM) is a valuable diagnostic modality for evaluating anorectal disorders. While rare, complications can occur including rectal perforation. We report a case of iatrogenic rectal perforation following ARM in a 77-year-old female with multiple prior rectal prolapse surgeries who was receiving chronic anticoagulation therapy. The patient developed rectal bleeding immediately post-procedure with subsequent imaging demonstrating retroperitoneal and mediastinal air. Flexible sigmoidoscopy revealed a 30% circumference rectal wall defect. Despite the extensive injury, the patient was hemodynamically stable without peritonitis. Conservative management consisting of bowel rest, broad-spectrum antibiotics resulted in complete resolution. Serial endoscopic evaluation confirmed full mucosal healing. This case demonstrates the importance of individualized procedural risk assessment in patients with prior anorectal surgery and underscores the feasibility of conservative management in stable cases of ARM-related rectal perforation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".