Snapshot quiz 14/2

Published: 02/14/2014

Authors: McIlmunn C, MacAulay G, Kirk G and Kennedy AJ

Anastomotic leak at the enteroenterostomy. During the initial procedure, the integrity of the gastrojejunostomy was assessed using methylene blue dye. At reoperation, an anastomotic leak secondary to staple-line failure at the enteroenterostomy was identified. The blue discoloration of the skin resulted from leakage of the dye at this site and subsequent extravasation through the port site. In addition to the physiological deterioration on day 1, the bright blue ‘bruising’ was a further cutaneous indication of an underlying anastomotic leak.