[Anastomotic leakage after gastro-intestinal surgery: a serious complication that is easily missed]

Abstract

Anastomotic leakage is a serious complication of gastro-intestinal surgery. Its prognosis is largely determined by early diagnosis and treatment, yet its symptoms can be aspecific and difficult to recognize in the postoperative phase. Here, we describe a case where recognition of serious anastomotic leakage was significantly delayed. This was due to the incorrect assumption that in the absence of abdominal pain, the deteriorating clinical condition of the patient was caused by aspiration pneumonia. What we learn is that a high index of suspicion of anastomotic leakage is required in the postoperative phase of gastro-intestinal surgery, even in the absence abdominal pain. Hence, CT imaging should be performed when in any doubt.