Anastomotic Leak

Common after GI surgery: oesophageal (10–20%), colorectal (3–10%, low rectum highest), gastric, pancreatic. Clinical features (often non-specific early): • Tachycardia (often FIRST sign — should not be ignored as 'normal post-op'). • Persistent fever > 48h post-op. • Increasing abdominal pain. • Ileus persisting / worsening. • Faeculent / purulent drain output. • Failure to progress (eating, mobilising). • Raised inflammatory markers (CRP >150 day 4 post-op = warning). • Sepsis / septic shock. Timing: most often day 5–7; up to 30 days post-op. ALWAYS suspect leak in unwell post-GI-surgery patient — escalate early.