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Anastomotic leak — USMLE Step 3 MCQ

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

A 63-year-old man is 5 days after low anterior resection. He develops fever, tachycardia, worsening abdominal pain, and oliguria. Abdomen is diffusely tender. White blood cell count is 18,000/mm3 and lactate is elevated. Which of the following is the most likely diagnosis?

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Correct answer: E — Anastomotic leak with intra-abdominal sepsis

Fever, tachycardia, peritonitis, and sepsis several days after bowel anastomosis are concerning for anastomotic leak.

Reference: ACS Surgery Principles