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Table 2 Complications of Roux-en-Y gastric bypass

From: Value of contrast-enhanced multidetector computed tomography in imaging of symptomatic patients after laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy

 

Complications and radiographic findings

Management

Early postoperative (n = 5)

Leaks (n = 2): (5.7%); within 2–4 days (Figs. 2 and 3))

Leakage was at the site of gastrojejunal anastomosis

Percutaneous drainage by pigtail catheter and insertion of naso-enteric tube.

Perigastric collection and hematoma (n = 3): (8.6%) within 3–7 days (Fig. 1)

The small collection was treated conservatively and the large collection was managed by gastro-jejunostomy

Late postoperative (n = 30)

Gatrojujenostomy anastomotic stricture (n = 1)

Endoscopic dilation of the stricture

Internal hernia (n = 14) (40%): 2–4 years (Fig. 4)

Altered disposition of loops and anastomosis

Twisting of mesenteric vessels (whirl sign)

Dilated bowel loops with mushroom appearance of the distended loops in the left hypochondrium

Mesenteric fat planes densification

Medical treatment (case 6)

Intestinal obstruction (n = 6) (17%): 2–4 years (Fig. 5)

Treated by laparoscopy (case 1)

Intussusception (n = 5) (14.3%): 2–4 years (Fig. 6)

( cases 20 and 21)

luminal narrowing (n = 1) (2.8%): 1 year

 

Distended bowel and weight gain (n = 2) (5.7%): after 4 years

 

Gastroesophageal spasm (n = 1) (2.8%): 9 months

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