RESUMEN
PURPOSE: Sleeve gastrectomy is a new bariatric surgical procedure with promising early results and low morbidity and mortality. We have evaluated the early imaging findings and value of upper GI study (UGI) and CT. PATIENTS AND METHODS: Twenty five patients (mean age=38.9 years, mean BMI=51.5 kg/m2) following sleeve gastrectomy for morbid obesity underwent UGI at day 1. CT was immediately performed in patients with suspected leak or as a follow-up examinations in patients with suspected complication. The different imaging features observed were recorded. RESULTS: UGI demonstrated 13 normal examinations (52%), an abnormal appearance in 11 cases (44%) with opacification of a lateral pouch, and one complication (leak confirmed on CT). Two patients underweent CT (day 3 and day 15) for suspected complication, with demonstration of leak in both cases. CONCLUSION: An abnormal appearance after sleeve gastrectomy is frequently observed on UGI. Routine UGI at day 1 is useful to detect large leaks. CT with oral contrast should be performed in all patients with imaging or clinical suspicion of leak.
Asunto(s)
Gastrectomía/métodos , Estómago/diagnóstico por imagen , Estómago/cirugía , Tomografía Computarizada por Rayos X , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo , Adulto JovenRESUMEN
The authors report a case of a complete pancreatic neck rupture treated by conservative surgery. A pancreatic neck rupture was diagnosed on a CT scan performed 24 hours after an abdominal blunt trauma. The patient was treated by suture of the cephalic remnant and Roux-en-Y pancreaticojejunostomy on the left remnant. Postoperative course was uneventful and the patient did not develop diabetes with a 18-month follow-up. This conservative technique, rarely used for complete pancreatic neck rupture, allows preservation of the pancreatic endocrine function.