Keywords:
Gastrointestinal tract, Abdomen, CT, Contrast agent-intravenous, Contrast agent-oral, Fistula, Eating disorders, Stomach (incl. Oesophagus)
Authors:
G. Scavone1, M. V. Raciti2, A. Giarrizzo3, F. Gulino1, F. Ferrara1, A. Bellia1, G. Galvano1, L. Piazza1, A. Basile1; 1Catania/IT, 2Pavia, IT/IT, 3Siracusa/IT
DOI:
10.1594/ecr2018/C-0775
Conclusion
The laparoscopic sleeve gastrectomy is one of the most common bariatric procedures.
LSG can be associated with three significant complications,
gastric bleeding,
gastric leaks and gastric strictures.
Of these the gastric leakage is the most feared complication.
Gastric leaks are associated with increase of hospitalization time,
morbidity and mortality.
The leak can lead to significant morbidity such as sepsis,
hemodynamic instability,
multiple organ failure (M.O.F.) and even death in 0-1,4% of cases.
The management of this complication can be conservative or interventional and includes drainage of intra-abdominal collections,
surgical decompression of the stomach,
surgical closure or endoscopic exclusion of the leakage,
CT-guided drainage positioning or gastric-oesophagi stenting.
In presence of a reasonable clinical suspect,
MDCT with both oral and intravenous contrast media administration is a robust technique for gastric leak identification and it is useful for surgical,
interventional radiologic or conservative treatment planning.
The administration of intravenous and oral contrast media is key factor for a confident diagnosis.