Advertisement

Imaging: What Are the Evidence-Based Strategies for Imaging the Bariatric Patient?

  • Christina S. HouserEmail author
  • Julie T. ViethEmail author
Chapter

Abstract

This chapter discusses the need for imaging, specifically computed tomography (CT), of bariatric patients presenting with signs or symptoms consistent with potential postoperative complications. In general, clinicians should have a low threshold to obtain imaging in the bariatric patient, as even vague complaints can have a lethal etiology. CT is indicated when assessing for gastric leak, intra-abdominal infection, and obstruction. However, any undifferentiated pain or fever, tachycardia, or leukocytosis without a clear source should prompt radiologic evaluation. Fluoroscopy may be beneficial to evaluate for band slippage, strictures, anastomotic narrowing, gastric outlet obstruction, or pouch dilation.

Keywords

Bariatric surgery Computed tomography Fluoroscopy Gastric leak Intra-abdominal infection Intra-abdominal abscess Band slippage Bowel obstruction 

References

  1. 1.
    Kurian M. Imaging studies after bariatric surgery. [Internet]. Uptodate.com. 2017 [cited 12 Sept 2017]. Available from: https://www.uptodate.com/contents/imaging-studies-after-bariatric-surgery?csi=c7f71472-51e6-48e6-9b36-786e77107419&source=contentShare.
  2. 2.
    Haddad D, David A, Abdel-Dayem H, Socci N, Ahmed L, Gilet A. Abdominal imaging post bariatric surgery: predictors, usage and utility. Surg Obes Relat Dis. 2017;13(8):1327–36.3.CrossRefGoogle Scholar
  3. 3.
    Miao T, Kielar A, Patlas M, Riordon M, Chong S, Robins J, et al. Cross-sectional imaging, with surgical correlation, of patients presenting with complications after remote bariatric surgery without bowel obstruction. Abdom Imaging. 2015;40(8):2945–65.CrossRefGoogle Scholar
  4. 4.
    Uppot R. Impact of obesity on radiology. Radiol Clin N Am. 2007;45(2):231–46.CrossRefGoogle Scholar
  5. 5.
    Guniganti P, Bradenham C, Raptis C, Menias C, Mellnick V. CT of gastric emergencies. Radiographics. 2015;35(7):1909–21.CrossRefGoogle Scholar
  6. 6.
    Chandler R, Srinivas G, Chintapalli K, Schwesinger W, Prasad S. Imaging in bariatric surgery: a guide to postsurgical anatomy and common complications. Am J Roentgenol. 2008;190(1):122–35.CrossRefGoogle Scholar
  7. 7.
    Levine M, Carucci L. Imaging of bariatric surgery: normal anatomy and postoperative complications. Radiology. 2014;270(2):327–41.CrossRefGoogle Scholar
  8. 8.
    Varghese J, Roy-Choudhury S. Radiological imaging of the GI tract after bariatric surgery. Gastrointest Endosc. 2009;70(6):1176–81.CrossRefGoogle Scholar
  9. 9.
    Carucci L, Turner M. Imaging after bariatric surgery for morbid obesity: roux-en-Y gastric bypass and laparoscopic adjustable gastric banding. Semin Roentgenol. 2009;44(4):283–96.CrossRefGoogle Scholar
  10. 10.
    Lehnert B, Moshiri M, Osman S, Khandelwal S, Elojeimy S, Bhargava P, et al. Imaging of complications of common bariatric surgical procedures. Radiol Clin N Am. 2014;52(5):1071–86.CrossRefGoogle Scholar
  11. 11.
    Lewis K, Takenaka K, Luber S. Acute abdominal pain in the bariatric surgery patient. Emerg Med Clin North Am. 2016;34(2):387–407.CrossRefGoogle Scholar
  12. 12.
    Ni Mhuircheartaigh J, Abedin S, Bennett A, Tyagi G. Imaging features of bariatric surgery and its complications. Seminars in Ultrasound, CT and MRI. New York: WB Saunders. 2013;34(4):311–324.CrossRefGoogle Scholar
  13. 13.
    Kothari S. Bariatric surgery and postoperative imaging. Surg Clin N Am. 2011;91(1):155–72.CrossRefGoogle Scholar
  14. 14.
    Lainas P, Tranchart H, Gaillard M, Ferretti S, Donatelli G, Dagher I. Prospective evaluation of routine early computed tomography scanner in laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(8):1483–90.CrossRefGoogle Scholar
  15. 15.
    Gaetke-Udager K, Wasnik A, Kaza R, Al-Hawary M, Maturen K, Cohan R. A guide to imaging in bariatric surgery. Emerg Radiol. 2014;21(3):309–19.CrossRefGoogle Scholar
  16. 16.
    de Bakker JK, Budde van Namen YW, Bruin SC, de Brauw LM. Gastric bypass and abdominal pain: think of Petersen hernia. J Soc Laparoendosc Surg. 2012;16(2):311–3.CrossRefGoogle Scholar
  17. 17.
    Lockhart ME, Tessler FN, Canon CL, et al. Internal hernia after gastric bypass: sensitivity and specificity of seven CT signs with surgical correlation and controls. AJR Am J Roentgenol. 2007;188:745–50.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.MedStar Washington Hospital Center, MedStar Georgetown University HospitalWashington, DCUSA
  2. 2.Canton-Potsdam HospitalPotsdamUSA

Personalised recommendations