McDermott et al reported a grading system for an anastomotic leak in a patient undergoing colorectal surgery. The authors are from St. Vincent's University Hospital, Ninewells Hospital (Dundee) and Salford Royal Hospitals NHS Foundation Trust.
Parameters:
(1) clinical signs of peritonitis
(2) hemodynamic changes
(3) additional clinical findings
Clinical Signs of Peritonitis
Hemodynamic Changes
Additional Clinical Findings
Grade
no
none
may have deviated from expected course; may show biochemical abnormalities
1
no
variable tachycardia responsive to therapy
signs of infection; amenable to abscess drainage; may show ileus
2
single quadrant
persistent tachycardia; normotensive
signs of infection with ileus; NG tube drainage and/or urinary catheter
3
multiple quadrants
tachycardia; hypotension; variable need for inotrope
