Table 1 Checklist for interpretation of early post-gastrectomy CT

Report pleuropulmonary changes at lung bases

Atelectasis, pneumonia, pleural effusion (see Fig. 8) or empyema (Fig. 14)

Quantify free intraperitoneal air and/or fluid

Discussion in text; see Fig. 10

Identify stapled or hand-sewn

- esophagojejunostomy (EJS) after total gastrectomy (Figs. 2 and 3)

- gastrojejunostomy (GJS) after partial gastrectomy (Figs. 5 and 6)

- look for localized air, fluid or haemorrhagic collections adjacent to either EJS or GJS (Figs.11 and 12)

Gastric remnant generally indicated by staple line

Efferent jejunal limb from EJS or GJS characterized by valvulae conniventes and tubular configuration on coronal viewing

Identify the closed duodenal stump (DS)

- assess dilatation (Fig. 15)

- look for adjacent collections (Figs. 6 and 9)

DS generally recognized by a metallic staple at its blind end (Figs. 5, 6, 7 and 9)

Report presence and site of drainage tubes

Assess post-splenectomy or post-pancreatectomy status

If performed (see Figs. 2, 3 and 11)

Assess patency of splenic, portal and mesenteric veins

For postoperative thrombosis, favoured by intra-abdominal sepsis

Exclude retained foreign bodies

E.g. surgical sponges (indicated by thin hyperattenuating structures), bioabsorbable haemostatic materials agents such as Gelfoam or Surgicel (which appear as walled heterogeneous masses with internal “mottled” gas bubbles)

Scrutinize laparotomy site

For abscess collections suggesting wound infection