case_images: PMC10866551_01
case_images: CT of the abdomen and pelvis with oral and IV contrast on POD 5 showing a dilated small intestine with no transitional point. The colon contains gas extending to the rectum, suggesting ileus rather than obstruction, and there is no evidence of a leak.. POD: Postoperative day.
case_images: cureus-0016-00000052314-i01.jpg
case_images: PMC10866551_01_cureus-0016-00000052314-i01.jpg
case_images: FIG1
case_images: A CT abdomen and pelvis with oral and IV contrast (CTAP) was performed, ruling out an anastomotic leak and collection, and indicated only the ileus without obstruction (Figure 1).
case_images: CT of the abdomen and pelvis with oral and IV contrast on POD 7 showing increased pneumoperitoneum and free fluid below both diaphragms, suggesting perforation with features of peritonitis. The ileocolic anastomosis appears unremarkable.. POD: Postoperative day.
case_images: cureus-0016-00000052314-i02.jpg
case_images: PMC10866551_01_cureus-0016-00000052314-i02.jpg
case_images: FIG2
case_images: A repeated CTAP on POD 7 revealed increased pneumoperitoneum and free fluid, suggesting perforation with peritonitis, although the ileocolic anastomosis appeared unremarkable (Figures 2-3).
case_images: CT of the abdomen and pelvis with oral and IV contrast on POD 7 showing increased pneumoperitoneum, suggesting perforation with features of peritonitis. The ileocolic anastomosis appears unremarkable.. POD: Postoperative day.
case_images: cureus-0016-00000052314-i03.jpg
case_images: PMC10866551_01_cureus-0016-00000052314-i03.jpg
case_images: FIG3
case_images: A repeated CTAP on POD 7 revealed increased pneumoperitoneum and free fluid, suggesting perforation with peritonitis, although the ileocolic anastomosis appeared unremarkable (Figures 2-3).
case_images: A follow-up CT of the abdomen and pelvis with oral and IV contrast showing sizable undrained collections anteriorly, in the subhepatic region, and at the left upper quadrant.
case_images: cureus-0016-00000052314-i04.jpg
case_images: PMC10866551_01_cureus-0016-00000052314-i04.jpg
case_images: FIG4
case_images: Cessation of inotropes and improved intra-abdominal pressure were observed two days later.  A follow-up CTAP revealed sizable undrained collections, leading to CT-guided drainage of 200 ml of pus-stained fluid (Figure 4).