Upper Gastrointestinal Tract Leaks

Abstract

Anastomotic leak remains a potentially disastrous complication of gastrointestinal surgery. Early diagnosis and management of these leaks is essential. Initial steps in the management of these leaks include airway management as necessary, resuscitation, and treatment of associated sepsis. Source control of leaked enteric contents and distal enteric access must follow. Endoscopic treatment modalities for upper gastrointestinal leaks include endoscopic stent placement, clip placement, endoscopic suturing, internal drainage, and endoscopic vacuum therapy. The application of these techniques has variable success depending on the size and location of the leak. These techniques continue to emerge as essential therapeutic modalities for gastrointestinal leaks and ultimately require the concomitant evolution of the endoscopist for the effective treatment of these complications.