Collection around ileocolic anastomosis

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Had right hemicolectomy and ileocolic anastomosis formation 1 week earlier. Now has pain and raised temperature and inflammatory markers.

Patient Data

Age: 35 years

CT abdomen and pelvis

ct

There is a gas and fluid containing collection extending from the level of the umbilicus to the pelvis, predominantly on the right side. It measures 15 cm in maximal diameter and is intimately related to the ileocolic anastomosis. A distended loop of jejunum is seen containing fecalised content, unchanged from prior imaging and due to a fibrostenotic stricture. A percutaneous gastrostomy is also present.

Case Discussion

The finding of a new gas and fluid containing collection with enhancing margins adjacent to an anastomosis is strongly suspicious for a leak.

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