C. Carter2, M. Burger1, M. S. O’Mara1,2 1Grant Medical Center,Trauma And Acute Care Surgery,Columbus, OHIO, USA 2Ohio University Heritage College Of Medicine,Athens, OHIO, USA
Introduction:
In evaluating for post-operative leaks in perforated ulcer repair, there is controversy around whether or not routine radiographs should be used. We hypothesize that postoperative contrast studies will effectively identify suture site leaks and help reduce complications by delaying gastric ingestion.
Methods:
316 patients that underwent surgical repair of a perforated ulcer were retrospectively evaluated. 178 of these patients were subjected to a radiographic study post-surgery. Data was recorded based on whether or not these radiographs were ordered due to protocol or secondary to patient symptoms. A chi square analysis, along with an odds ratio, where then performed.
Results:
Of the patients subjected to a planned contrast study, it was found that 5.6% (9/161) were diagnosed with a leak. The remaining 17 patients underwent a radiograph secondary to symptoms where 4 shown leaks (23.5%). A chi-square analysis was performed and statistical significance was found where p= 0.0069. When the contrast study was performed secondary to symptoms, leaks were 5.2 times more likely to be found.
Conclusion:
Postoperative contrast studies effectively identify suture site leaks and help with reducing complications by delaying gastric ingestion. When contrast studies were performed secondary to symptoms, leaks were 5.2 times more likely to be found. Statistical significance was found; therefore it is more effective to use patient symptoms as a guideline for postoperative contrast studies as opposed to prophylactic radiographs.