Morgenstern et al graded the severity of leakage following a colonic anastomosis. The authors are from Cedars-Sinai Medical Center in Los Angeles.


Major leak - one or more of the following:

(1) direct cause of death

(2) spreading peritonitis (not limited, diffuse)

(3) sepsis with one or more organ failures


Moderate leak - one or more of the following:

(1) confined to the perianastomotic site or pelvis

(2) diameter of accumulation > 5 cm

(3) sepsis with moderate severity

(4) morbidity resulting in prolonged hospitalization


Minor leak - any of the following and does not meet criteria for moderate or major leak:

(1) no or limited morbidity

(2) limited, short-term fecal drainage

(3) diameter of accumulation <= 5 cm (based on size criteria for moderate leak)

(4) incidentally discovered sinus tract

(5) minor extravasation seen on an imaging study of the anastomosis


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