Studying the complications of bariatric surgery with intravenous contrast-enhanced multidetector computed tomography

Abstract

Objective

To review the complications of bariatric surgery and their diagnosis with intravenous contrast-enhanced multidetector computed tomography (MDCT).

Material and methods

We retrospectively studied all patients who underwent gastric bypass or sleeve gastrectomy at our center during 2013 or 2014. We classified complications into early complications (appearing within 30 days of the intervention) and late complications.

Results

We reviewed 155 cases and found 24 complications in 22 patients: 16 early complications (7 intraperitoneal hematomas, 5 anastomotic dehiscences, 2 intestinal obstructions, and 2 external hernias) and 8 late complications (3 internal hernias, 3 intestinal perforations, and 2 marginal ulcers). Two patients died. All of these complications were diagnosed with intravenous contrast-enhanced MDCT, except one, which required a barium transit study.

Conclusion

The rate of complications in bariatric surgery is high and the associated mortality is not negligible. Radiologists need to know the normal findings in these patients so they can quickly identify possible complications, most of which can be diagnosed with intravenous contrast-enhanced MDCT.

Resumen

Objetivo

Revisar las complicaciones de la cirugía bariátrica y su diagnóstico mediante tomografía computarizada multidetector con contraste intravenoso (TCMDcCIV).

Material y métodos

Estudio retrospectivo de los pacientes intervenidos mediante by-pass gástrico o gastrectomía tubular en nuestro centro durante 2013 y 2014. Las complicaciones se dividieron en precoces (durante el primer mes) y tardías.

Resultados

Se revisaron 155 casos y se diagnosticaron 24 complicaciones en 22 pacientes: 16 precoces (7 hematomas intraperitoneales, 5 dehiscencias anastomóticas, 2 obstrucciones intestinales y 2 hernias externas) y 8 tardías (3 hernias internas, 3 perforaciones intestinales y 2 úlceras en boca anastomótica). Dos pacientes fallecieron. Todas las complicaciones se diagnosticaron mediante TCMDcCIV, excepto una que requirió un tránsito baritado.

Conclusión

La tasa de complicaciones en la cirugía bariátrica es elevada y su mortalidad no es despreciable. Deben reconocerse los hallazgos normales en estos pacientes para identificar rápidamente las posibles complicaciones, diagnosticadas en su mayoría mediante TCMDcCIV.