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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.
