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Clin Colon Rectal Surg 2021; 34(06): 412-416
DOI: 10.1055/s-0041-1735273
Review Article

Special Considerations of Anastomotic Leaks in Crohn's Disease

N. Nimalan A. Jeganathan
1   Division of Colorectal Surgery, Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
,
Walter A. Koltun
1   Division of Colorectal Surgery, Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
› Author Affiliations Funding This work was supported by the Peter and Marshia Carlino Early Career Professorship Award for Inflammatory Bowel Disease Research.
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Abstract

Rates of anastomotic leak following intestinal resections in the setting of inflammatory bowel disease are significantly influenced by clinical characteristics. While the literature can be contradictory due to significant heterogeneity in the published data, several common themes appear to consistently arise. With respect to Crohn's disease, low serum albumin, preoperative abscess, reoperative abdominal surgery, and steroid use are associated with an increased risk of postoperative intra-abdominal septic complications. On the contrary, biologic therapy, immunomodulator use, and method of anastomosis appear not to confer increased anastomotic-related complications. Undoubtedly, a low rate of anastomotic leakage is inherent to procedures within colorectal surgery but diligent attention must be paid to identify, optimize, and, therefore, reduce known risks.

Keywords

Crohn's disease - anastomotic leak - hypoalbuminemia - intra-abdominal abscess - steroids - biologics


Publication History

Article published online:
01 October 2021

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