Learning objectives
Explain the main findings and complications of abdominal surgery.
Differentiate pathology from normal immediate findings that can be found in the post surgical abdomen.
Establish protocols and simple guidelines that allow the characterization of these findings.
Background
Suspected complication of abdominal surgery is a frequent and often urgent consultation on radiology services which has led to an increase in additional tests,
particularly computed tomography (CT).
Clinical signs are often subtle and difficult to distinguish from normal postoperative changes,
and so the importance of the imaging tests.
For the proper interpretation of these imaging tests,
the radiologist should be aware of the medical history,
the performed surgical procedure and its possible complications.
Findings and procedure details
Normal findings in the post abdominal surgery (Figs 1 and 2)
After surgery there are findings that we can consider as postsurgical normal changes.
They may be related or not with the patient's clinical and are often difficult to distinguish from pathology.
Pneumoperitoneum
It is the presence of air within the peritoneal cavity.
This finding is usually considered abnormal and indicative of bowel perforation.
Nevertheless,
it is considered normal in some contexts as surgery,
since it involves opening of this cavity.
● In the case...
Conclusion
CT plays an integral role in the evaluation of normal postoperative anatomy and identification of complications.
Performance and diagnostic accuracy of CT relates to the use of optimized protocols.
Radiologist must have previous clinical information about the suspected diagnosis and type of surgery performed to properly choose the appropriate protocol and differentiate normal postsurgical findings from pathological ones.
References
1.- Hindman N,
Kang S,
Parikh M.
Common Postoperative Findings Unique to Laparoscopic Surgery.
RadioGraphics 2014;34:119–38.
doi:10.1148/rg.341125181.
2.- Roberts A,
Fanous R,
Jaffer N,
McLeod R,
Chawla T,
Au W,
et al.
Guide to Surgical Procedures on Hollow Viscera: Part 1???Esophageal,
Gastric,
and Restrictive Bariatric Procedures.
American Journal of Roentgenology 2012;199:66–75.
doi:10.2214/AJR.10.7286.
3.- Roberts A,
Fanous R,
Jaffer N,
McLeod R,
Chawla T,
Au W,
et al.
Guide to Surgical Procedures on Hollow Viscera: Part 2???Colorectal,
Ostomy,
and Malabsorptive Bariatric Procedures.
American Journal of Roentgenology...