Learning objectives
The aim of this educational poster is to illustrate the role of upper gastrointestinal series (UGS) in detecting the most common and some more rare complications in patients who underwent bariatric surgery procedures as
laparoscopic adjustable gastric band (LAGB) placement,
laparoscopic sleeve gastrectomy (LSG),
Roux-en-Y gastric bypass (RYGB).
Our centre (Radiology Unit - Department of Medicine - University Hospital of Padova,
Italy) excels in the follow-up of patients who underwent bariatic surgery interventions (in the Week Surgery Unit of the same Hospital).
For this reason,...
Background
Bariatric surgery,
since its origin,
had improved and nowadays has generally a general low risk of post-procedural complications; patients,
on average,
are discharged from the hospital 2-3 days after the intervention.
Despite this,
in some patients,
expecially in those with comorbidity and the superobese (those with BMI > 40 kg/m2),
the early complication rate might be higher,
extending recovery times and lenghtening the hospedalization times.
In other patients,
the onset of late complications,related to surgical technique,
eating habits and other factors,
can be observed.
In...
Findings and procedure details
Complications in LAGB
In patients with LAGB,
UGS can identify various abnormalities connected with the gastric banding system (rotation,
dislocation,
rupture of the band,
breakage of the subcutaneous port or of the connection tube) and organic damages such as gastric stenosis,
prolapse,
and gastric wall erosion.
In fig.
4 we present some cases in which the connection tube between the port and the gastic band is interrupted (connection tube breakage or disconnection).
This can be subsequent to a trauma or can be spontaneous.
The main...
Conclusion
Our review offered to every radiologist somegateways to the interpretationwith UGS of a possible postsurgical complication after LAGB positioning and LSG or RYGB interventions.
The collaboration with the surgeon is important to managein real time some of the complications and to plan the subsequent therapeutic path.
Note that despite being often the first choice examination,
and despite being the plain or dynamic radiograms in many cases sufficient to make a diagnosis,
when a major or a general complication is suspected,
a CT scanmust be performed...
Personal information
Alberto Bertesso,
MD,
Radiology Resident
Silvia Karem Janet Flores Quispe,
MD,
Radiology Resident
Lorenzo Ugo,
MD,
Radiology Resident
Giulio Barbiero,
MD,
Radiologist
Monica Zuliani,
MD,
Radiologist
Fabio Pomerri,
Professor,
Radiologist
Radiology Unit - Department of Medicine - University of Padova
Via N.
Giustiniani,
2 - 35128,
Padova - Italy
[email protected]
[email protected]
References
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LAP-BAND© AdjustableGastric Banding (LAGB©) System Summary of Safety and EffectivenessData.
PMA No.
P000008.
Issued June 5,
2001.
Rockville,MD: FDA; June 3,
2002.
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Pomhoff I,
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Makarewicz W,
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2007;17(10):1297–305.
[3]Vidal P,
Ramón JM,
Busto M,
Domínguez-Vega G,
Goday A,
Pera M,et al.
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