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Anastomotic leak — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Anastomotic leakUSMLE Step 3

A 70-year-old man is postoperative day 5 after low anterior resection. He develops fever, tachycardia, abdominal pain, and leukocytosis. CT shows pelvic fluid with extraluminal contrast. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: D — Breakdown of the bowel anastomosis

Fever, sepsis physiology, abdominal pain, and extraluminal contrast after bowel resection indicate an anastomotic leak.

Reference: American College of Surgeons perioperative care principles