Document Detail

Colo-rectal anastomotic leakage often masquerades as a cardiac complication.
MedLine Citation:
PMID:  14692947     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The aim of this study was to identify the mode of presentation of patients with clinical anastomotic leaks following restorative colorectal resection for carcinoma. PATIENTS AND METHODS: Prospective information was collected on all patients having restorative resection of colorectal cancer. These data were reviewed for a five-year period (1994-1998) to identify all patients who had suffered a clinical anastomotic leak and their notes were retrieved and reviewed. RESULTS: Three hundred and seventy-nine patients underwent restorative resection for colorectal cancer during the study period (178 female, 201 male), mean age 70 years (range 36-94). There were 22 (6%) clinical anastomotic leaks. Seven (32%) patients presented with obvious abdominal peritonitis. The remaining 15 (68%) were initially misdiagnosed. Thirteen (59%) patients were treated for cardiac symptoms, 1 (5%) patient for obstruction and 1 (5%) for ascites. The delay in diagnosis ranged from 0 to 11 days (mean 4 days). For the whole series of 379 there were 30 patients who suffered cardiac symptoms (8%) 13(43%) of whom had an anastomotic leak. CONCLUSION: Patients who develop cardiac symptoms following restorative colorectal resection for carcinoma should have a water soluble enema as there is a 40% chance that they will have an anastomotic leak.
C D Sutton; L J Marshall; N Williams; D P Berry; W M Thomas; M J Kelly
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  6     ISSN:  1462-8910     ISO Abbreviation:  Colorectal Dis     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-24     Completed Date:  2004-06-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  21-2     Citation Subset:  IM    
Department of Surgery, Leicester General Hospital, Leicester, UK.
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MeSH Terms
Aged, 80 and over
Anastomosis, Surgical / adverse effects
Colon / surgery*
Colorectal Neoplasms / surgery*
Diagnostic Errors
Heart Diseases / diagnosis*
Middle Aged
Postoperative Complications / diagnosis*
Prospective Studies
Rectum / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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