The Clavien-Dindo classification grades surgical complications. A patient develops a post-operative anastomotic leak requiring re-laparotomy under general anaesthesia. What Clavien-Dindo grade is this?

• A Grade II
• B Grade IIIa
• C Grade IIIb ✓
• D Grade IVa

Explanation

Clavien-Dindo grading: Grade I = any deviation from normal post-op course not requiring pharmacological/surgical/radiological/endoscopic intervention; Grade II = pharmacological treatment including blood transfusion; Grade IIIa = intervention without general anaesthesia; Grade IIIb = intervention requiring general anaesthesia; Grade IVa = life-threatening complication requiring ICU/single organ dysfunction; Grade IVb = multi-organ dysfunction; Grade V = death. An anastomotic leak requiring re-laparotomy under general anaesthesia is Grade IIIb — the key distinction is whether general anaesthesia is used.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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