What is the ideal choice of contrast media for the detection of perforation or postoperative anastomotic leak?
- Water-soluble contrast agents are the medium of choice for the radiographic evaluation of patients with suspected upper GI perforation or postoperative leak.
- However, water-soluble media are less sensitive in the detection of leaks in comparison with barium because they are less radiopaque.
- In cases in which an initial study using iodinated contrast medium fails to demonstrate a suspected perforation, a repeat study using barium should be performed because small leaks may go undetected.
