# Anastomotic fart: a ubiquitous general surgical term not described in literature demonstrated in a case report

## TL;DR

This paper introduces and describes the term 'anastomotic fart' through a case report of a patient who avoided surgery after developing post-operative gas leakage.

## Contribution

The paper introduces the term 'anastomotic fart' as a new, informal descriptor for a specific surgical phenomenon not previously documented in literature.

## Key findings

- A 90-year-old patient developed a new pneumoperitoneum 10 days post-surgery but was managed conservatively.
- The term 'anastomotic fart' was successfully used to describe a case with gas leakage but minimal contamination.
- The patient was discharged after 24 days without requiring further surgical intervention.

## Abstract

Post-operative pneumoperitoneum following abdominal surgery usually resolves within one week but may persist for 10 to 24 days (Gayer G, Hertz M, Zissin R. Postoperative pneumoperitoneum: prevalence, duration, and possible significance. Semin Ultrasound CT MR. 2004;25:286–9). However, a new or enlarging volume of pneumoperitoneum following bowel resection is almost inevitably a sign of catastrophe (Gayer G, Hertz M, Zissin R. Postoperative pneumoperitoneum: prevalence, duration, and possible significance. Semin Ultrasound CT MR. 2004 Jun;25(3):286–9, Chiarello MM, Fransvea P, Cariati M, Adams NJ, Bianchi V, Brisinda G. Anastomotic leakage in colorectal cancer surgery. Surg Oncol. 2022;40:101708). Operative management is usually required in these cases (Chiarello MM, Fransvea P, Cariati M, Adams NJ, Bianchi V, Brisinda G. Anastomotic leakage in colorectal cancer surgery. Surg Oncol. 2022;40:101708). ‘Anastomotic fart’ is a commonly used phrase in General Surgical departments, often used to denote an anastomotic leak of gas only and minimal to no faecal contamination of the peritoneal cavity. However, this term is devoid in any published literature. In this case we demonstrate an ‘anastomotic fart’ managed conservatively by describing a 90 year old man who developed a new massive pneumoperitoneum on Day 10 post-operatively. He was able to avoid further surgical management and was safely discharged back to his own home after 24 days.