PMC6159306_01
CT scan with intravenous and oral contrast showing air and a faint suggestion of oral contrast outside of the suture, late phase (arrow). P, posterior; R, right.
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When the patient arrived at our centre, the CT films from the outside hospital were reviewed by our radiologists and there was concern that there was air and a faint suggestion of oral contrast outside of the suture line (Figure 1).
(a) Upper gastrointestinal series, early phase. (b) Upper gastrointestinal series, late phase. Arrow indicates extravasated extraluminal contrast representing leak on CT.
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During the early phase, no leak was observed, owing, in part, to the slow passage of 30 ml oral non-ionic contrast (Figure 2a). Only after delayed imaging and with administration of additional non-ionic contrast for a total of about 65 ml (approximately 2 h after the start of the fluoroscopic examination) was there a faint suggestion of extravasated contrast, best seen below the left hemidiaphragm (Figure 2b).
CT scan with contrast confirming leak, late phase. Arrow indicates extravasated extraluminal contrast and air representing leak on CT.
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Follow-up CT scan with oral contrast confirmed the obvious leak (Figure 3).