Presentation
Sigmoid colectomy for diverticular disease 1 week ago. Fecal discharge from site of pelvic drain post-open sigmoid colectomy. Bowel perforation or leak?
Patient Data
Small thin tract arising from the posterior aspect of the mid rectum at the site of anastomosis with a large volume of contrast extravasation into the presacral space in keeping with an anastomotic leak.
Anastomosis at level of the rectosigmoid.
Defect on the posterior side of the colon gas/fluid collection and fat stranding in the presacral space.
Pneumoperitoneum anterior to the liver.
The liver, pancreas, spleen, adrenals and kidneys are unremarkable.
Case Discussion
Typical appearances of an anastomotic leak. The traditional fluoroscopic study beautifully illustrates the site and nature of the leak.
The patient returned to theater for surgical management.
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