X-rays help physicians diagnose and treat gastric band slippage

Standard radiography (X-rays) can help physicians diagnose laparoscopic adjustable gastric band slippage, a known complication of adjustable gastric banding surgery, according to a study published in the July issue of the American Journal of Roentgenology. Adjustable gastric banding surgery is a widely used bariatric surgical procedure to induce weight loss in morbidly obese individuals.

As adjustable gastric banding surgery becomes common, more patients are presenting to the emergency department with complications of the procedure, particularly those resulting from slippage of the gastric band. "Because the consequences of slippage may require acute surgical intervention, it is imperative that the radiologist is familiar with the surgical technique to correctly position the band and the appearances of a gastric band when correctly and incorrectly positioned," said Sabrina Pieroni, MD, lead author of the study.

Researchers from Boston Medical Center in Boston, MA, reviewed the radiologic findings in 55 consecutive patients who underwent laparoscopic gastric banding. Gastric band slippage was diagnosed and surgically confirmed in four patients. "In all four patients with surgically proven gastric band slippage, the initial abdominal X-ray showed an O-shaped configuration of the gastric band, which we have termed the "O" sign," said Pieroni. In each case, the O-shaped configuration of the band was a change from its rectangular appearance when in the proper position.

"As adjustable banding is increasingly used, more patients will present to the emergency department with complications of the procedure, particularly complications from band slippage," said Pieroni.

"Identification of the O sign on radiography can potentially aid the radiologist, surgeon, or emergency department physician in the early detection of gastric band slippage and appropriate patient triage," she said.

(Source: Amercian Roentgen Ray Society: American Journal of Roentgenology: July 2010)