[Postoperative sonography in gastrectomized patients. Correlations with gastrografin swallow. Value in the detection of complications with special reference to anastomosis insufficiency].

In a group of patients (n = 102) we compared post-total gastrectomy plus splenectomy the ranking of the postoperative Gastrografin swallow and of abdominal sonography as "bedside" methods. There was no correlation in respect of proof of anastomotic insufficiency on the one hand and detection of free abdominal fluid on the other. No other imaging method visualises morphological details of the anastomosis to the same degree as the Gastrografin swallow. The water-soluble contrast medium used so far appears to be in need of improvement in respect of "x-ray density", viscosity and osmolarity, the more so since the danger of aspiration is high in the postoperative, debilitated patient. The first ranking of sonography is due to its ability to detect free abdominal fluid and pathological findings in the abdominal walls. The postoperatively formed "neo-compartments" in the peritoneal cavity in the upper abdomen render the classification of pathological findings as belonging to certain organ structures even more difficult. Ultrasound supplies important additional information in respect of the position of peritoneal drainages and also concerning the basal thoracic segments that are important in x-ray film of the thorax. Sonographic monitoring of the drainage of abscesses is possible. In the synopsis of both methods, further diagnostic measures (CT, leucocyte scan) are only rarely necessary (3% of the cases).