1Ali Barah, 2Israa Al-Hashimi, 1Rahil Kassamali, 1Qayed Aldebyani, 1Omran Almokdad, 1Ayman Elmagdoub, 1Mohammed Khader, 1Saad U Rehman, 1Ahmed Omar

1Clinical Imaging Department, Hamad Medical Corporation, Doha, Qatar; 2College of Medicine, Qu Health, Qatar University, Doha, Qatar

 

Background:

• To enumerate the most common PSGC
• To delineate the imaging findings of complications following SG
• To emphasize the role of IR in managing these complications

Methods:

Cases of PSGCs with the significant role of IR in the management of complications were retrospectively reviewed and placed on the following categories based on the CT findings:

  1. Gastric leak
  2. Intra-abdominal abscess or collection
  3. Gastric stricture
  4. Early or delayed bleedings
  5. Porto-mesentric thrombosis

IR has demonstrated to have a significant role in the management of the majority of complications related to SG, reducing the risks of surgical reintervention:

  1. In the case of a gastric leak: By the deployment of the gastric stent under fluoroscopic guidance.
  2. In case of intra-abdominal abscess or collection: By inserting percutaneous catheter drainage under CT or US guidance.
  3. In case of gastric stricture at the surgical site: By performing balloon dilatation under fluoroscopy guidance.
  4. In case of early or delayed bleedings: By performing selective arterial angiography and embolization.
  5. In case of porto-mesentric thrombosis: By performing percutaneous endovascular thrombectomy and thrombolysis.

Conclusion:

PSGC are rare but can be life-threatening. Correct diagnosis of the complications and appropriate interventional procedures can be performed in patients suffering from the complications, particularly when repeated surgical treatment cannot be endured. IR can restore various organs’ function by preventing the progression of early and late PSGC, reducing the significantly associated comorbidities and long-term mortality through its safe and effective minimally invasive image-guided procedures.