CLINICAL & BASIC RESEARCH
SQU Med J, December 2010, Vol. 10, Iss. 3, pp. 354-360, Epub. 14
th
Nov 10
Submitted 19
th
March 10
Revision ReQ. 15
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June 10, Revision recd. 7
th
August 10
Accepted 15
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August 10
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: Objectives: his study is a single institution retrospective evaluation of imaging indings of small bowel
obstruction (SBO) after retrocolic antegastric Roux-en-Y gastric bypass surgery for morbid obesity. Methods: he
radiological database of 490 patients who underwent gastric bypass surgery for morbid obesity from January 2001-
2005 at the Royal Victoria Hospital McGill University Health Center was searched for SBO complications related to
the procedure. here were 22 cases of small bowel obstruction related to the procedure. Ten patients had abdominal
and pelvic computed tomography (CT) scans, 12 patients had upper gastrointestinal (UGI) and small bowel follow
through (SBFT). Results: Among 22 cases of SBO, 14 cases were due to anastomotic stenosis or adhesion, 7 due to
internal hernia and one to jejuno-jejunal intussusception. Among the 14 patients with SBO related to adhesion and
anastomotic narrowing, 11 patients were managed medically and 3 cases managed surgically. CT scans correctly
diagnosed 4 out of 5 cases including the 3 patients managed surgically and UGI and SBFT examinations diagnosed
the remaining 9 cases that were managed medically. Among the 7 patients with internal hernias, CT scans correctly
diagnosed 2 out of 4 cases, while UGI and SBFT examinations correctly diagnosed 1 out of 3. he jejuno-jejunal
intussusception was correctly diagnosed by CT scan. Conclusion: he most frequent cause of SBO is anastomotic
narrowing or adhesion. CT scan remains the most appropriate imaging modality in diagnosing acute presentation
of SBO caused by internal hernia or adhesion/anastomotic narrowing. UGI and SBFT appear more appropriate for
diagnosing the subacute insidious presentation of adhesive partial SBO.
Keywords: Gastric bypass surgery; Small bowel obstruction; Morbid obesity; Anastomotic narrowing
Imaging of Small Bowel Obstruction following
Gastric Bypass Surgery for Morbid Obesity
A retrospective review
*Rashid Al-Sukaiti,
1
Lawrence Stein,
2
Nicholas Christou,
2
Benoit Mesurolle,
2
Giovanni P Artho
2
CLINICAL & BASIC RESEARCH
1
Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman;
2
Royal Victoria Hospital,
Department of Diagnostic Radiology and Surgery, McGill University Health Center, Montreal, Canada.
*Corresponding Author email: rsketty@hotmail.com