Abstract

AbstractThere are only a few reports in the literature describing the postoperative radiologic appearance of anastomoses after operation on the colon, and most of these describe the end-to-end anastomosis of a colocolostomy on the left colon. The purpose of this paper is to report the radiologic appearance of the anastomotic site after right colectomy. Sixty patients who had resections of the right colon were studied postoperatively by barium and air contrast enemas and, in some instances, by examinations of the small bowel. Eighteen patients had deformities in and about the anastomotic site which caused some difficulty in interpretation. This was particularly true when a blind pouch was present after a lateral or end-to-side anastomosis and the inverted and of the gut produced an irregular contour. Most of the deformities were recognized on follow-up examinations but one patient required operation to rule out a recurrent tumor. Two patients had recurrent carcinoma at the anastomotic site. Three patients had obstruction of the ileum due to adhesions. It is suggested that a postoperative barium and air contrast enema be done three months after operation to provide a base line, and thereafter annually. If there is any question as to recurrence of disease at the anastomotic site, surgical exploration should be considered. The significance of the investigation was to determine the radiologic appearance oft he anastomotic site in order to have some knowledge of the postoperative changes. If the surgical changes are recognized radiologically, some patients may be spared a needless operation.