Presentation
Day 2 post-sleeve gastrectomy, presenting with severe epigastric pain, fever, and vomiting.
Patient Data
postoperative changes related to sleeve gastrectomy
moderate fluid density intermixed with contrast agents within the abdominopelvic cavity
tubular stomach associated with extravasation of contrast material and gas in the left upper quadrant with downward extension toward the left paracolic gutter and pelvic cavity due to a postoperative leak mostly at the gastroesophageal junction
mild bilateral pleural effusion
Case Discussion
The patient presented with severe epigastric pain, fever, and vomiting shortly after a sleeve gastrectomy. The clinical presentation and CT features are in keeping with staple line leakage mostly at the gastro-esophageal junction. Leak after sleeve gastrectomy often occurs in the first few days postoperative due to failure of staple line complete closure.
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