Postoperative Anastomotic Leak Clinical Manifestations

Anastomotic leak is a complication that can occur after gastrointestinal surgery, characterized by tissue defect at the surgical site where two ends of the intestine are joined. This defect allows intestinal contents to escape into the abdominal cavity, potentially leading to severe complications. This condition is most commonly observed following colorectal surgeries and typically develops between the 5th and 7th day post-operation.

Patients may present with symptoms such as fever, abdominal pain, nausea, vomiting, and signs of peritonitis, which indicate intra-abdominal infection. These symptoms often arise when digestive fluids or food particles pass through the leak into the abdominal cavity, triggering an inflammatory response.

To diagnose an anastomotic leak, clinicians may administer contrast agents or dyes such as methylene blue through the gastrointestinal tract or a nasogastric tube. If dye appears in the drainage fluid, it strongly suggests the presence of an anastomotic leak. The severity of the leak is generally classified into three categories—A, B, and C—with A and B being manageable through non-surgical interventions such as antibiotics, nutritional support, and drainage. However, category C leaks require immediate surgical intervention to repair the anastomosis and prevent life-threatening septic complications.

Early detection and appropriate management are crucial in improving patient outcomes and reducing morbidity associated with anastomotic leakage.