Radiologists have identified two earlier undescribed radiologic signs of potentially life-threatening slippage of laparoscopically adjustable gastric bands. Furthering widespread knowledge of the new signs—the inferior displacement of the superolateral band margin by more than 2.4 cm from the diaphragm and the presence of an air-fluid level above the band on a frontal X-ray—to radiologists’ knowledge base will help diagnose the affected bariatric patients.
These signs of grave complications are seen on upright frontal scout radiographs, enabling radiologists accustomed with the signs to accurately diagnose slippage from chest or abdominal radiography alone, instead of the more time-consuming barium swallow.
“The indication in publications within the past decade that a normal gastric band should project 4–5 cm below the diaphragm is confusing and potentially misleading given that the modern pars flaccida surgical technique intentionally places the band at or within 2 cm of the esophagogastric junction,” the researchers wrote in their article, published July 2014 in the American Journal of Roentgenology.
The investigators, from the department of diagnostic imaging, Alpert Medical School of Brown University (Providence, RI, USA), Rhode Island Hospital (Providence, RI, USA), and the department of radiology, Mercy St. Vincent Medical Center (Toledo, OH, USA), reported their findings July 2014 in the American Journal of Roentgenology (AJR).
Alpert Medical School of Brown University
Mercy St. Vincent Medical Center