title: Disruption of a stapled anastomosis following therapeutic ultrasonics--is there a risk? Report of a case.
abstract: OBJECTIVE
  We examined the theoretic possibility that therapeutic ultrasound can disrupt a stapled gastrointestinal anastomosis.
  
  
  METHODS
  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.
  
  
  RESULTS
  Ultrasound intensity at the anastomosis in this patient was calculated at 10 to 46 mW/cm2.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Edgbaston, Birmingham, United Kingdom.
authors.forename: A J
authors.initials: AJ
authors.lastname: Makin
authors.forename: A W
authors.initials: AW
authors.lastname: Garnham
authors.forename: M R
authors.initials: MR
authors.lastname: Keighley
mesh_terms: D000714:Anastomosis, Surgical; D001416:Back Pain / Q000628:therapy; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008875:Middle Aged; D012307:Risk Factors; D017792:Surgical Stapling; D013529:Surgical Wound Dehiscence / Q000209:etiology*; D014464:Ultrasonic Therapy / Q000009:adverse effects*