Suspected Anastomotic Leak
Fever, tachycardia, pain, ileus, drain output
All Pathways
Colorectal SurgeryManagement
Anastomotic Leak Management Algorithm (ASCRS)
Anastomotic Leak Management Algorithm (ASCRS): Suspected Anastomotic Leak → CT with Contrast → Leak Confirmed → Patient Status → Contained Leak - Stable.
Pathway Overview
9 steps
Algorithm Steps
9 total
01Start 02Action CT with Contrast
Oral/rectal contrast may help
03Decision Leak Confirmed
- Contained
- Free perforation/peritonitis
04Decision Patient Status
- Stable/contained
- Septic/unstable
05Action Contained Leak - Stable
Small, draining, no sepsis
06End Non-Operative Management
NPO, antibiotics, percutaneous drain
07End Endoscopic Management
Endo-VAC, stent, or clip for selected leaks
08Action Sepsis/Peritonitis
Hemodynamic instability, diffuse contamination
09End Operative Management
Washout, drainage, diversion ± takedown
Guideline Source
ASCRS Clinical Practice Guidelines: Anastomotic Leak
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Management depends on clinical status
- Contained leaks may be managed non-operatively
- Early recognition critical
Applicable Regions
USAUUKEU
UK: Enhanced recovery programs emphasize early detection
US: ASCRS guidelines
Version 1Next review: 2028-01-01
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Related Resources
Frequently Asked Questions
What is the Anastomotic Leak Management Algorithm (ASCRS)?
The Anastomotic Leak Management Algorithm (ASCRS) is a management clinical algorithm for Colorectal Surgery. It provides a structured decision tree to guide clinical decision-making, based on ASCRS Clinical Practice Guidelines: Anastomotic Leak.
What guideline is the Anastomotic Leak Management Algorithm (ASCRS) based on?
This algorithm is based on ASCRS Clinical Practice Guidelines: Anastomotic Leak (DOI: 10.1097/DCR.0000000000001578).
What are the limitations of the Anastomotic Leak Management Algorithm (ASCRS)?
Known limitations include: Management depends on clinical status; Contained leaks may be managed non-operatively; Early recognition critical. Individual patient factors may require deviation from these recommendations.
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