Normal and Abnormal Postoperative Imaging Findings after Gastric Oncologic and Bariatric Surgery

Abstract Objectives To compare the prevalence of pre- and postoperative osseous deformities and intra-articular lesions in patients with persistent pain following arthroscopic femoroacetabular impingement (FAI) correction and to identify imaging findings associated with progressive cartilage damage. Methods Retrospective study evaluating patients with hip pain following arthroscopic FAI correction between 2010 and 2018. Pre- and postoperative imaging studies were analyzed independently by two blinded readers for osseous deformities (cam-deformity, hip dysplasia, acetabular overcoverage, femoral torsion) and intra-articular lesions (chondro-labral damage, capsular lesions). Prevalence of osseous deformities and intra-articular lesions was compared with paired t-tests/McNemar tests for continuous/dichotomous data. Association between imaging findings and progressive cartilage damage was assessed with logistic regression. Results Forty-six patients (mean age 29 ± 10 years; 30 female) were included. Postoperatively, 74% (34/46) of patients had any osseous deformity including 48% (22/46) acetabular and femoral deformities. Ninety-six percent (44/46) had an intra-articular lesion ranging from 20% (9/46) for femoral to 65% (30/46) for acetabular cartilage lesions. Prevalence of hip dysplasia increased (2 to 20%, p = 0.01) from pre- to postoperatively while prevalence of cam-deformity decreased (83 to 28%, p < 0.001). Progressive cartilage damage was detected in 37% (17/46) of patients and was associated with extensive preoperative cartilage damage > 2 h, i.e., > 60° (OR 7.72; p = 0.02) and an incremental increase in postoperative alpha angles (OR 1.18; p = 0.04). Conclusion Prevalence of osseous deformities secondary to over- or undercorrrection was high. Extensive preoperative cartilage damage and higher postoperative alpha angles increase the risk for progressive degeneration. Key Points • The majority of patients presented with osseous deformities of the acetabulum or femur (74%) and with intra-articular lesions (96%) on postoperative imaging. • Prevalence of hip dysplasia increased (2 to 20%, p = 0.01) from pre- to postoperatively while prevalence of a cam deformity decreased (83 to 28%, p < 0.001). • Progressive cartilage damage was present in 37% of patients and was associated with extensive preoperative cartilage damage > 2 h (OR 7.72; p = 0.02) and with an incremental increase in postoperative alpha angles (OR 1.18; p = 0.04).

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Bariatric Surgery and Postoperative Imaging

Surgical Clinics of North America ◽

10.1016/j.suc.2010.10.013 ◽

2011 ◽

Vol 91 (1) ◽

pp. 155-172 ◽

Cited By ~ 11

Author(s):

Shanu N. Kothari

Keyword(s):

Bariatric Surgery ◽

Postoperative Imaging

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Pancreaticoduodenectomy with venous resection and reconstruction: current surgical techniques and associated postoperative imaging findings

Abdominal Radiology ◽

10.1007/s00261-017-1290-5 ◽

2017 ◽

Vol 43 (5) ◽

pp. 1193-1203 ◽

Cited By ~ 4

Author(s):

Ammar A. Javed ◽

Karen Bleich ◽

Fabio Bagante ◽

Jin He ◽

Matthew J. Weiss ◽

...

Keyword(s):

Surgical Techniques ◽

Imaging Findings ◽

Venous Resection ◽

Postoperative Imaging

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The Utility of Postoperative Computed Tomography Imaging Following Isolated Orbital Blowout Fracture Repair

Craniomaxillofacial Trauma & Reconstruction ◽

10.1177/1943387520922048 ◽

2020 ◽

Vol 13 (3) ◽

pp. 198-204

Author(s):

Sara E. Francomacaro ◽

Jana A. Bregman ◽

Kalpesh T. Vakharia ◽

Francis L. Grumbine

Keyword(s):

Computed Tomography ◽

Medical Records ◽

Fracture Repair ◽

Imaging Findings ◽

Inclusion Criteria ◽

Computed Tomography Imaging ◽

Postoperative Imaging ◽

Reduce Radiation Exposure ◽

Blowout Fracture ◽

Care Costs

Purpose: To determine the clinical utility of computed tomography (CT) imaging following isolated orbital blowout fracture (OBF) repair. Methods: Single-center retrospective review of adult patients undergoing surgical repair of isolated OBFs between November 2008 and August 2016 who received postoperative CT scans. Preoperative and postoperative examination data, postoperative imaging reads, postoperative courses, and any reoperation documentation were collected from electronic medical records. Postoperative imaging findings were categorized as major, indeterminate, or minor by predicted impact on clinical management. Major findings indicated a need for reoperation, indeterminate a potential reoperation, and minor no reoperation. Results: Fifty-two cases met inclusion criteria: 94.2% (n = 49) of postoperative scans included minor findings, 34.6% (n = 18) indeterminate findings, and 19.2% (n = 10) major findings. Three patients returned to the operating room (OR) for surgical revision. All 3 had a significant and concerning change on postoperative examination. Only 1 also had a major finding on postoperative imaging. The remaining 49 patients had benign postoperative examinations, despite 9 (17.3%) with major imaging findings who did not undergo reoperation. Conclusions: In the majority of OBF repairs, postoperative CT scan findings were not predictive of a need to return to the OR for revision. Reoperation was instead largely prompted by concerning changes in the postoperative clinical examination. Our findings suggest that postoperative imaging in the absence of clinical concern should not be included in the surgical management of isolated OBFs. Instead, targeted imaging will help reduce radiation exposure and health-care costs without sacrificing patient care.

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Clinically silent magnetic resonance imaging findings after subdural strip electrode implantation

Journal of Neurosurgery ◽

10.3171/2009.6.jns09228 ◽

2010 ◽

Vol 112 (2) ◽

pp. 461-466 ◽

Cited By ~ 9

Author(s):

Faisal A. J. Al-Otaibi ◽

Abdullah Alabousi ◽

Jorge G. Burneo ◽

Donald H. Lee ◽

Andrew G. Parrent ◽

...

Keyword(s):

Mr Imaging ◽

Type A ◽

Electrode Placement ◽

Imaging Findings ◽

Type B ◽

Postoperative Imaging ◽

Common Location ◽

Asymptomatic Patients ◽

Imaging Results ◽

Electrode Insertion

Object Subdural strip electrodes (SSEs) are often used as part of the workup in patients being considered for epilepsy surgery. To assess for complications or to confirm electrode placement, postoperative imaging is often performed. Imaging performed with the electrodes in situ is limited by streak artifact on CT and susceptibility artifact on MR imaging. Therefore, the first opportunity for high-quality postoperative imaging is following explantation of electrodes. There is no data available to determine what would be the expected MR imaging appearance following insertion of SSE. The purpose of this study is to describe the MR imaging findings in asymptomatic patients who underwent insertion of SSEs. Methods Twenty consecutive patients who underwent SSE insertion were studied. Within 24 hours after removal of the electrodes, each patient underwent MR imaging that included axial T2-weighted, gradient echo, diffusion weighted, and coronal FLAIR sequences. No significant symptoms were reported by any of the patients. The studies were reviewed by an experienced, blinded neuroradiologist and categorized. Results Of the 20 patients studied, 11 were female (mean age 36 years). Clinically silent postexplantation MR imaging abnormalities were found in all patients: subdural hematomas in 7 (35%), cortical contusions in 5 (25%), local edema in 5 (25%), trans–bur hole cortical herniation in 5 (25%), subdural hygromas in 2 (10%), and pneumocranium in 4 (20%). The MR imaging abnormalities were subdivided into 2 types: Type A, abnormalities related to the site of electrode insertion; and Type B, abnormalities related to the location of the electrodes. The most common location for a Type A abnormality was occipitotemporal, with cortical contusions occurring in this location in 18% of cases, local edema in 24%, and trans–bur hole herniation in 24%. The next most common location was frontal, with cortical contusions found in this location in 10% of cases, local edema in 5% and trans–bur hole herniation in 5%. The most common Type B abnormality was a subdural hematoma, followed by pneumocranium and subdural hygroma. Conclusions Clinically silent MR imaging abnormalities are common following SSE placement. Knowledge of these findings would be of assistance in interpreting MR imaging results in patients being assessed for complications.

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