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Fig. 3C —Roux-en-Y gastric bypass procedure. Axial CT image of upper abdomen performed without IV contrast after Roux-en-Y gastric bypass procedure in 36-year-old woman shows small gastric pouch filled with dense, orally introduced contrast (black arrow). Adjacent, but surgically separated, is most of stomach, gastric remnant (white arrow). Surgical staples separating the two are seen (arrowhead). Dilute oral contrast in remnant has refluxed via duodenum. This should not be mistaken for direct leak from pouch (gastrogastric fistula), which will manifest with dense oral contrast in remnant without any in distal duodenum.