Colonic anastomotic leak
The
anatomical compartments and their connections as demonstrated by ectopic air. Anastomotic colorectal leak during a CT colonoscopy in a 81-year-old woman with a history of excision of recto-sigmoid adenocarcinoma 8 years previously. Coronal (a) and sagittal (b) reformatted CT scan. Continuity of the transversalis fascia with the parietal endopelvic fascia is depicted
Colonic anastomotic leaks occur in the early or late postoperative phase, in which the enteric anastomosis fails. This may be a small leak that can be managed conservatively or less commonly complete dehiscence requiring repeat surgery.
Epidemiology
In one large surgical series, the incidence anastomotic leak after colorectal resection was 8.7% .
Radiographic features
Fluoroscopic water soluble enema or CT with rectal contrast are the usual methods of radiological assessment.
Practical points
The use of barium is contraindicated because if there a leak and spill of barium into the peritoneal cavity it can cause a chronic chemical peritonitis.
