TITLE:
Correlation between Water-Soluble Contrast CT Colonography Findings and Colonic Anastomotic Complications: Experience Based on Three Case Reports
AUTHORS:
Abdoulaye Koné, Ouncoumba Diarra, Kassim Sidibe, Moussa D. Sangare, Karamoko Kouyate, Youlouza Coulibaly, Dembele Mamadou, Moussa Traore, Mahamadou Diallo, Adama Diaman Keita, Hamed Pierre Toure, Siaka Sidibe
KEYWORDS:
CT Colonography, Water-Soluble, Anastomosis, Colorectal, Fistulas, Stenosis
JOURNAL NAME:
Open Journal of Radiology,
Vol.16 No.3,
September
30,
2026
ABSTRACT: Introduction: Postoperative anastomotic complications of the colon, including strictures and fistulas, are a major cause of morbidity after colorectal surgery. Early detection relies on high-precision imaging that allows characterization of the lesion and helps guide the therapeutic strategy. The aim of this study was to assess the contribution of water-soluble contrast CT colonography in the postoperative follow-up of colorectal anastomoses. Observations: We report three cases of patients who underwent a water-soluble contrast CT colonography to evaluate complications that occurred within two months after a colorectal anastomosis. This is a prospective descriptive study carried out in the imaging department of Polyclinique Pasteur over a six-month period (from January 1 to June 30, 2025), including three patients who had undergone surgery with a colonic anastomosis. The three patients in the study were examined using a contrast-enhanced CT scan. This single-center study, limited by a small sample size and the inexperience of the radiology technicians, showed a male predominance (sex ratio = 1.5). The surgical indications were digestive perforation complicating a diverticular sigmoiditis, an adenocarcinoma of the upper rectum, and an obstruction caused by a sigmoid volvulus. Two patients had an end-to-end colonic anastomosis and the other had an end-to-side anastomosis. The complications observed included an anastomotic stricture, three anastomotic fistulas without involvement of nearby organs, and a hydro-aeric effusion complicated by peritonitis. Finally, only one patient received care through interventional radiology. Conclusion: This work highlights the high diagnostic value of CT colonography in the postoperative monitoring of patients who have had colon surgery and its essential role in detecting and characterizing anastomotic complications.