Disruption of a stapled anastomosis following therapeutic ultrasonics--is there a risk? Report of a case.

Abstract

We examined the theoretic possibility that therapeutic ultrasound can disrupt a stapled gastrointestinal anastomosis. A case is reported in which leakage of a stapled ileocolic anastomosis occurred following therapeutic ultrasound. Calculations are performed on the power of the ultrasound beam and its adsorption and dispersion in the tissue between the probe and anastomosis to establish its intensity at the anastomosis. Ultrasound intensity at the anastomosis in this patient was calculated at 10 to 46 mW/cm2. Although the calculated ultrasound intensities at the anastomosis do not appear to be very high, other factors such as "pressure doubling" and "stress concentration" at the stapled surface suggest that therapeutic ultrasound may cause staple disruption.