Pelvic abscess is usually the result of a leak or disruption of the ileoanal anastomosis, leak from the pouch suture line, or an infected haematoma. The prevalence of postoperative pelvic sepsis varies between 5% and 25% [40-42], this wide range being partially attributable to the lack of a standard defini tion. Symptoms and signs include fever, anal pain, tenesmus, purulent discharge, bleeding from the anus and leukocytosis. Diagnosis may be established by examination under anaesthesia alone or in combination with imaging studies such as contrast pou-chography, computerised tomography (CT) and magnetic resonance imaging (MRI). Pelvic sepsis may be clinically evident in the immediate postoperative period, after ileostomy closure or after a long follow-up period. Late sepsis may be expressed as pouch dysfunction with frequency, urgency, incontinence or pouch-related fistula without systemic signs of sepsis. The treatment is modified according to the severity of sepsis. Some patients can be managed successfully with antibiotic treatment while others will need operative or CT-guided percutaneous drainage. It is clear that severe pelvic sepsis with extensive anastomotic breakdown results in a high failure rate despite salvage attempts .
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