Presentation
Vomiting in the outcome of bariatric surgery with gastric banding
Patient Data
Rx gas-barium double-contrast
Abnormal horizontal positioning of the gastric band with increased phi (φ) angle measurement of 88° (normal, 4°–58°). Radiopaque contrast is visible in the gastric fundus, which is distended secondary to obstruction from the slipped lap band. The band is placed approximately 3 cm below the gastro-esophageal junction.
Case Discussion
The band's angle relative to the spine (phi (φ) angle) should normally be 4°–58°, and the anterior and posterior aspects of the band should be superimposed. It is placed about 2 cm below the gastroesophageal junction, forming a small gastric pouch. If the band slips distally towards a larger stomach segment, it can lead to obstruction or volvulus.
Case courtesy Dr.ssa Sandra Pennacchini
Radiographer: TSRM Fabio Imola