Persistent tachycardia, fever, rising abdominal pain, ileus or a falling urine output in the days after a bowel anastomosis can precede overt peritonitis. Treat the trend, not a single number: reassess the patient, check inflammatory markers and lactate, and consider early imaging or return to theatre per your unit's protocol.
Senior review early is cheaper than late recognition.
- Look for a trend in heart rate, temperature and pain, not one reading.
- Examine the abdomen and review drain output if present.
- Send bloods including CRP and lactate and consider CT.
- Involve the senior surgeon early.
Why it matters
Delayed recognition of leak is a major driver of morbidity after colorectal surgery.
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