Radiological manifestations of bariatric surgeries

Abstract

Bariatric surgeries have been increasing in prevalence as the obesity epidemic climbs in the United States. As with any surgery, bariatric procedures come with their respective risks and complications which are generally well depicted in radiological studies. Traditionally, fluoroscopy has been an accepted form of evaluating anatomy, obstruction, and leaks. With the rise in cross sectional imaging methods, abdominal computed tomography (CT) has provided much more specificity to identify and characterize major complications. This review article will demonstrate the imaging findings and complications of the most common bariatric surgeries performed in the southeast United States at a single, large tertiary care center: Roux-en-Y gastric bypass, adjustable gastric band, and sleeve gastrectomy. This image-rich comprehensive review presents the radiological manifestations of the anatomy and potential complications of these bariatric surgeries primarily through the modalities of CT and CT-angiography (CTA) with the occasional assistance of fluoroscopy. It is crucial for general radiologists, emergency medicine physicians, and surgeons to recognize these imaging findings as they will frequently encounter patients with complications in their clinical settings. While one anastomosis gastric bypass (OAGB) and single-anastomosis duodenal-ileal switch (SAIDS) surgeries are other recognized bariatric procedures, these are not commonly performed regionally and therefore post-operative images of these procedures and complications are excluded.