Roux-en-Y gastric bypass: major complications.
OBJECTIVE
To describe normal anatomy of Roux-en-Y gastric bypass (GBP) surgery. To know the spectrum of major complications, time of appearance and imaging findings.


BACKGROUND
Roux-en-Y GBP surgery nowadays represents a successful treatment of morbid obesity. From January 1999 to June 2005, 148 patients with Roux-en-Y GBP surgery have been reviewed. Within a period of 24-72 h after surgery, upper gastrointestinal series was performed. The radiographic manifestations of normal anatomy and follow-up major complications are illustrated in this pictorial essay. We compare the CT and other imaging findings with clinical and surgical findings.


RESULTS
A total of 14 follow-up major complications occurred in 9 of 148 patients. Only 3 were early complications, the other 11 were late and appeared between 1 month and 4 years. Imaging findings of stomal stenosis, gastric staple line dehiscence, leaks, jejunal and gastric wall necrosis, small bowel obstruction due to adhesions, loculated fluid collection and celiac trunk stenosis are illustrated.


CONCLUSIONS
It is important for the radiologist to be familiarized with the radiographic manifestations of normal anatomy and major complications after Roux-en-Y GBP. These may be life-threatening and usually appear as late complications. An adequate imaging technique and a prompt evaluation by the radiologist can help to minimize them.
Andrés
Marina
M
Department of Radiology, Hospital 12 de Octubre, Av Córdoba, Madrid, Spain. martape@ozu.es
Pérez
Marta
M
Roldán
José
J
Borruel
Susana
S
de la Cruz Vigo
Javier
J
Azpeitia
Javier
J
Alvarez
Elena
E
Carrera
Roberto
R
Muñoz
Verónica
V
D000328:Adult; D000714:Anastomosis, Surgical; D003251:Constriction, Pathologic; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications; D011856:Radiographic Image Enhancement; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods