Clin Colon Rectal Surg 2021; 34(06): 391-399
DOI: 10.1055/s-0041-1735270
Review Article

Diagnosis of Anastomotic Leak

Paul T. Hernandez
1   Division of Colorectal Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
,
Raj M. Paspulati
2   Department of Radiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio
,
Skandan Shanmugan
3   Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
› Author Affiliations
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Abstract

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.



Publication History

Article published online:
23 November 2021

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