Introduction: Postoperative anastomotic complications of the colon, including strictures and fistulas, are a major cause of morbidity after colorectal surgery. Early detection relies on high-precision imaging that allows characterization of the lesion and helps guide the therapeutic strategy. The aim of this study was to assess the contribution of water-soluble contrast CT colonography in the postoperative follow-up of colorectal anastomoses. Observations: We report three cases of patients who underwent a water-soluble contrast CT colonography to evaluate complications that occurred within two months after a colorectal anastomosis. This is a prospective descriptive study carried out in the imaging department of Polyclinique Pasteur over a six-month period (from January 1 to June 30, 2025), including three patients who had undergone surgery with a colonic anastomosis. The three patients in the study were examined using a contrast-enhanced CT scan. This single-center study, limited by a small sample size and the inexperience of the radiology technicians, showed a male predominance (sex ratio = 1.5). The surgical indications were digestive perforation complicating a diverticular sigmoiditis, an adenocarcinoma of the upper rectum, and an obstruction caused by a sigmoid volvulus. Two patients had an end-to-end colonic anastomosis and the other had an end-to-side anastomosis. The complications observed included an anastomotic stricture, three anastomotic fistulas without involvement of nearby organs, and a hydro-aeric effusion complicated by peritonitis. Finally, only one patient received care through interventional radiology. Conclusion: This work highlights the high diagnostic value of CT colonography in the postoperative monitoring of patients who have had colon surgery and its essential role in detecting and characterizing anastomotic complications.
References
[1]
Vilgrain, V. and Regent, D. (2010) Imagerie de l’abdomen. Lavoisier, 1055 p.
[2]
Mathias, J., Barbary, C., Meyer-Bisch, L., Tissier, S., Laurent, V., Beot, S., et al. (2005) L’eau et les hydrosolubles iodés comme contrastes endoluminaux en scanographie du tube digestif. Feuillets de Radiologie, 45, 273-287. https://doi.org/10.1016/s0181-9801(05)80602-5
[3]
Zins, M., Loriau, J., Boulay-Coletta, I., Julles, M., Petit, E. and Sauvanet, A. (2009) Imagerie post-opératoire du pancréas et du duodénum. Journal de Radiologie, 90, 918-936. https://doi.org/10.1016/s0221-0363(09)73232-9
[4]
Hoeffel, C., Marra, C., Azizi, L., Bouché, O. and Tubiana, J. (2009) Postoperative Imaging after Colorectal Surgery. Journal de radiologie, 90, 954-968.
[5]
Audett, M.C. and Paquette, I.M. (2014) Intraoperative and Postoperative Diagnosis of Anastomotic Leak Following Colorectal Resection. Seminars in Colon and Rectal Surgery, 25, 54-57. https://doi.org/10.1053/j.scrs.2014.04.001
[6]
Maiga, A.H. (2018) Early Postoperative Complications in Visceral Surgery at Gao Hospital. Medical Thesis, University of Sciences, Techniques and Technologies of Bamako, 15-35.
[7]
Marres, C.C.M., van de Ven, A.W.H., Leijssen, L.G.J., Verbeek, P.C.M., Bemelman, W.A. and Buskens, C.J. (2017) Colorectal Anastomotic Leak: Delay in Reintervention after False-Negative Computed Tomography Scan Is a Reason for Concern. Techniques in Coloproctology, 21, 709-714. https://doi.org/10.1007/s10151-017-1689-6
[8]
Benzazoua, A. and Soufi, N.I. (2017) Etude descriptive des anastomoses digestives au service de CHIRURGIE A CHU TLEMCEN DU 01/07/2016 AU 31/01/2017 [Descriptive Study of Digestive Anastomoses in the Surgery Department of CHU Tlemcen from 01/07/2016 to 31/01/2017]. Doctoral Dissertation, Université Abou Bakr Belkaid. https://www.sahla-dz.com/memoires/100700/
[9]
Brigand, C., Rohr, S. and Meyer, C. (2004) L’anastomose colorectale mécanique: Résultats après résection antérieure du rectum pour cancer. Annales de Chirurgie, 129, 427-432. https://doi.org/10.1016/j.anchir.2004.07.009
[10]
Majbar, M.A., Courtot, L., Dahbi-Skali, L., Rafik, A., Jouppe, P.O., Moussata, D., et al. (2022) Two-Step Pull-Through Colo-Anal Anastomosis Aiming to Avoid Stoma in Rectal Cancer Surgery: A “Real Life” Study in a Developing Country. Journal of Visceral Surgery, 159, 187-193. https://doi.org/10.1016/j.jviscsurg.2021.04.004
[11]
Bequis, A., Gonzalez, M., Fernandez Aramburu, J., Huespe, P., Duran, S., Hyon, S.H., et al. (2020) Fluoroscopy and Endoscopy-Guided Transanastomotic Rendezvous: A Novel Technique for Recanalization of a Completely Obstructed Colorectal Anastomosis. International Journal of Colorectal Disease, 36, 627-631. https://doi.org/10.1007/s00384-020-03781-x
