Closure of a perineal sinus connected with the small bowel developing after radical surgery for rectal carcinoma: a report of the operative procedures used in two cases.

A technique for closure of a perineal sinus connected with the small bowel is described herein. One patient who underwent Miles' operation and another who underwent total pelvic exenteration for rectal carcinoma developed a perineal sinus through which a large amount of intestinal fluid was discharged. The pelvic orifice of the sinus was successfully closed in both patients using a right rectus abdominis muscle flap. In one patient, the muscle flap was reflected with the peritoneal surface inside and fixed to the pelvic floor covering the pelvic orifice of the sinus. In the other patient, the flap was isolated without the attached peritoneum and the peritoneal side of the flap covered with omentum.