The Controversial Role of Prophylactic Drainage: Case Report

We present the case of a 72-year-old diabetic and hypertensive female patient who underwent colorectal resection for adenocarcinoma, with mechanical anastomosis and prophylactic pre-anastomotic drainage.The postoperative course was marked by diabetic ketoacidosis, thrombocytopenia, and a deterioration of the general condition.On the second postoperative day, the drain yielded blackish fluid, accompanied by fever, abdominal distension, and a significant increase in CRP and procalcitonin levels.A CT scan of the abdomen and pelvis revealed peritoneal infiltration, a large amount of pneumoperitoneum, peri-anastomotic air bubbles, and an intra-luminal drain, prompting urgent surgical re-intervention.Exploration confirmed an anastomotic leak with the presence of the drain inside the anastomosis. A Hartmann’s colostomy was performed.This case highlights the controversial role of prophylactic drainage, which may contribute to the occurrence of anastomotic fistulas.