Disruption of colonic anastomosis during continuous epidural analgesia. An early postoperative complication.

Summary The clinical presentation is described of partial rupture of a colonic anastomosis two hours after surgery during epidural analgesia. The unusually early presentation of this complication is possibly due to removal of normal intestinal sympathetic activity by epidural analgesia resulting in normal or increased colonic motility. It is not known whether epidural analgesia may precipitate anastomotic breakdown due to increased contractions and strain on the anastomosis, or lead to an earlier presentation of a disruption caused by failure of surgical technique or other factors.