Ideal choice of contrast media for the detection of perforation or postoperative anastomotic leak

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.

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