Presentation
Insufficient weight loss after sleeve gastrectomy surgery performed 2 years ago. CT volumetry of the gastric pouch to assess the volume of the sleeved stomach before revisionary bariatric surgery.
Patient Data
Note the morbid obesity noted on the scout image. The scout film is used to allow rapid assessment of adequate gastric distension before imaging.
CT 3D images show a dilated sleeved stomach showing loss of its banana shape with a mean volume of 576 cm3.
Case Discussion
CT gastrography is performed with oral administration of effervescent granules.
Sleeve gastrectomy is a bariatric surgery in which most of the stomach is vertically resected, leaving only a narrow “Magenstrasse”. The volume of the remaining sleeve should be about 50-200 ml in the early postoperative period, which is controlled by using a calibration tube during the procedure1. Sleeve dilatation is a late complication 2. The direct relationship between an increase in gastric reservoir volume, and a lower weight loss after surgery is documented 3.
MS CT gastrography and volumetry are helpful for assessment of the sleeved stomach volume especially in the setting of revisionary surgery.
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