Anastomotic Leaks After Small- and Large-Bowel Surgery: Diagnostic Performance of CT and the Importance of Intraluminal Contrast Administration

Samji, Karim; Kielar, Ania Z.; Connolly, Michael; Fasih, Najla; Doherty, Geoffrey P.; Chung, Andrew D.; Hache, Etienne

doi:10.2214/ajr.17.18642

Cited by 22 publications

(23 citation statements)

References 18 publications

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“…CT imaging findings may be definitive of anastomotic leak, but additional imaging with water soluble contrast enema or small bowel follow through may be necessary to confirm the leak. 85…”

Section: Radiologic Diagnosis Of Anastomotic Leakagementioning

confidence: 99%

“…3). 85,89 Mural edema of the bowel, decreased mural enhancement, and obstruction at the anastomosis are more specific but less commonly seen imaging signs for an AL (►Fig. 3).…”

Section: Entero-enteric Ileo-colic and Colo-colic Anastomotic Leaksmentioning

confidence: 99%

“…4 and 5). 85 In the CT protocol with positive intraluminal contrast, it is important to see that contrast reaches the bowel anastomosis site. The main disadvantage with positive intraluminal contrast is that the bowel wall enhancement and possible ischemia cannot be assessed.…”

Section: Entero-enteric Ileo-colic and Colo-colic Anastomotic Leaksmentioning

confidence: 99%

“…A single-center retrospective case control study for bowel AL has sensitivity of 64.9% for CT without intraluminal contrast and increased to a sensitivity of 74.3% for CT with positive intraluminal contrast. 85 CT is also useful to assess more distant peritoneal collections and guidance for percutaneous abscess drainage. Patients with inflammatory bowel disease, on immunosuppressive therapy or anti-vascular endothelial growth factor (VEGF) agents, such as bevacizumab (Avastin), are at high risk for postoperative anastomotic leaks with complex…”

Section: Entero-enteric Ileo-colic and Colo-colic Anastomotic Leaksmentioning

confidence: 99%

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Diagnosis of Anastomotic Leak

Hernandez

Paspulati

Shanmugan

2021

Clin Colon Rectal Surg

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Anastomotic leaks after colorectal surgery is associated with increased morbidity and mortality. Understanding the impact of anastomotic leaks and their risk factors can help the surgeon avoid any modifiable pitfalls. The diagnosis of an anastomotic leak can be elusive but can be discerned by the patient's global clinical assessment, adjunctive laboratory data and radiological assessment. The use of inflammatory markers such as C-Reactive Protein and Procalcitonin have recently gained traction as harbingers for a leak. A CT scan and/or a water soluble contrast study can further elucidate the location and severity of a leak. Further intervention is then individualized on the spectrum of simple observation with resolution or surgical intervention.

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“…CT imaging findings may be definitive of anastomotic leak, but additional imaging with water soluble contrast enema or small bowel follow through may be necessary to confirm the leak. 85…”

Section: Radiologic Diagnosis Of Anastomotic Leakagementioning

confidence: 99%

“…3). 85,89 Mural edema of the bowel, decreased mural enhancement, and obstruction at the anastomosis are more specific but less commonly seen imaging signs for an AL (►Fig. 3).…”

Section: Entero-enteric Ileo-colic and Colo-colic Anastomotic Leaksmentioning

confidence: 99%

Section: Entero-enteric Ileo-colic and Colo-colic Anastomotic Leaksmentioning

confidence: 99%

Section: Entero-enteric Ileo-colic and Colo-colic Anastomotic Leaksmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis of Anastomotic Leak

Hernandez

Paspulati

Shanmugan

2021

Clin Colon Rectal Surg

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“…La tomografía computarizada contrastada con medio hidrosoluble es el estudio de imagen más usado para el diagnóstico de FA, pero la literatura no es concluyente en cuanto a que sea lo mejor (sensibilidad del 74,3% frente al 68% sin contraste) 7 .…”

Section: Introductionunclassified

Factores de riesgo asociados a fuga anastomótica intestinal en cirugía electiva

Bolívar-Rodríguez¹,

Magaña-Olivas²,

Cázarez-Aguilar³

et al. 2022

CIRU

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Objetivo: Analizar los factores de riesgo asociados a la fuga de anastomosis intestinal en cirugía electiva. Método: Estudio observacional y retrospectivo en el que se recabaron los expedientes de los pacientes operados de anastomosis intestinal en forma electiva en un hospital de segundo nivel de enero de 2007 a enero de 2017. Resultados: Se incluyeron 64 pacientes, de los cuales siete presentaron fuga de la anastomosis. Los factores de riesgo asociados a fuga anastomótica estadísticamente significativos fueron consumo de cocaína (p = 0.030), neoplasia como patología primaria (p = 0.008), tratamiento con neoadyuvantes para neoplasia (p = 0.003) y anastomosis término-terminal (p = 0.037). Los pacientes con fuga tuvieron una estancia intrahospitalaria más prolongada y una mortalidad del 14.3%. Conclusiones: Los factores de riesgo asociados con la presencia de fuga anastomótica encontrados en este estudio son consistentes con los reportados en la literatura mundial. Sin embargo, en nuestros resultados cabe destacar el uso de cocaína como factor de riesgo, con significancia estadística.

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