The Teaching Point

A major complication of Roux-En-Y gastric bypass surgery is internal hernia, which has a mortality rate of more than 50% and is often misdiagnosed. Key CT findings that can aid clinicians in diagnosing internal hernia include swirled mesentery, mushroom sign, hurricane eye, small-bowel obstruction, clustered loops, small bowel behind the superior mesenteric artery, and right-sided anastomosis.






Bookmark and Share

From the manuscript

Importance of CT in Evaluating Internal Hernias after Roux-en-Y Gastric Bypass Surgery

Free full text article: Importance of CT in Evaluating Internal Hernias after Roux-en-Y Gastric Bypass Surgery

Abstract
As the incidence of obesity increases, laparoscopic Roux-en-Y gastric bypass (REYGB) surgery has become a surgical option for many patients. Although the laparoscopic Roux-en Y procedure has been shown to reduce weight and improve diabetes, hyperlipidemia, hypertension and sleep apnea, it is not without significant risks, as more than 10% of patients who undergo this procedure have postoperative GI complications. This is a case of a 51 year old man who presented with diffuse abdominal pain one month status-post Roux-en-Y gastric bypass. CT imaging proved to be crucial in the diagnosis of this pathology with small bowel volvulus and ischemia. We review some key CT findings that can aid clinicians in diagnosing internal hernias since this complication is often misdiagnosed and have a mortality rate of more than 50%.






References



1. DeMaria, EJ. Bariatric surgery for morbid obesity. N Engl J Med, 2007 356(21): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


2. Buchwald H. Bariatric surgery: a systematic review and meta-analysis. JAMA, 2004 292(14): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


3. Chandler RC. Imaging in bariatric surgery: a guide to postsurgical anatomy and common complications. Am J Roentgenol, 2008 190(1): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


4. Blachar A. Gastrointestinal complications of laparoscopic Roux-en-Y gastric bypass surgery: clinical and imaging findings. Radiology, 2002 223(3): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


5. Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. Am J Roentgenol, 2006 186(3): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


6. Blachar A, Federle MP. Gastrointestinal complications of laparoscopic roux-en-Y gastric bypass surgery in patients who are morbidly obese: findings on radiography and CT. Am J Roentgenol, 2002 179(6): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


7. Lockhart ME. Internal hernia after gastric bypass: sensitivity and specificity of seven CT signs with surgical correlation and controls. Am J Roentgenol, 2007 188(3): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


8. Garza E. Internal hernias after laparoscopic Roux-en-Y gastric bypass. Am J Surg, 2004 188(6): p
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine




Search for articles with similar topics:

Keyword search:

1. Roux-en-Y gastric bypass

2. Internal hernia


This article belongs to the GI section.


Search for more in the Internet

Peer-reviewed Radiology Search




Discuss it!

Bookmark and Share




© Journal of Radiology Case Reports - The Interactive Radiology Journal
Affiliated journal of Radiolopolis - The International Radiology Community


The Journal of Radiology Case Reports