Anastomotic Leak Flashcards Preview

Y3M - Perioperative Care > Anastomotic Leak > Flashcards

Flashcards in Anastomotic Leak Deck (10)
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1
Q
A
1
Q

Definition anastomotic leak

A

Leak of luminal contents from a surgical join

They are the most important complication to recognise following GI surgery

2
Q

Risk factors

A

Medication like corticosteroids and immunosuppressant

Smoking or alcohol excess

DM

Obesity or malnutrition

Emergency surgery

Longer intra-op time

Peritoneal contamination (from pus, faeces, GI contents)

Oesophageal-gastric

3
Q

Clinical features

A

Abdominal pain and fever

5-7 days post-OP usually.

Pyrexial, tachycardic +/- features of peritonism.

Check for faeculent/purulent material or bile in any drains.

4
Q

Investigations

A

CT abdo pelvis with IV contrast is the definitive investigation

Early resus and senior input

Urgent blood tests with FBC, CRP, U&Es, LFTs and clotting screen

VBG to assess degree of tissue perfusion

Repeat G&S

5
Q

Initial management

A

NBM + start broad spectrum abx cover per local guidelines.

Start IV fluids and insert a urinary cath to monitor fluid balance

6
Q

Definitive management for minor leaks

A

May be managed conservatively

Collections of <5cm will usually settle with IV abx

7
Q

Definitive management for major leaks

A

Drained percutaneously if possible.

8
Q

Management if the patient is septic or has multiple collections?

A

Exploratory laparotomy with large drain insertion

9
Q
A