Optimal Use of Computed Tomography in Diagnosing Internal Herniation After Roux-en-Y Gastric Bypass: A Proposition for the Application of a Radiological Prediction Score - Summary - MDSpire

Optimal Use of Computed Tomography in Diagnosing Internal Herniation After Roux-en-Y Gastric Bypass: A Proposition for the Application of a Radiological Prediction Score

  • By

  • Lilian L. van Hogezand

  • Lucas Goense

  • Erik J.R.J. van der Hoeven

  • Charlotte J. Tutein Nolthenius

  • Niek van Oorschot

  • Luigi A.M.J.G. van Riel

  • Marinus J. Wiezer

  • Niels A.T. Wijffels

  • Marijn Takkenberg

  • Wouter W. Te Riele

  • Lea M. Dijksman

  • Hjalmar C. van Santvoort

  • Wouter J.M. Derksen

  • October 18, 2025

  • 0 min

Share

Objective:

To develop a reproducible prediction score for diagnosing internal herniation in patients post-RYGB, enhancing clinical decision-making based on structured assessment of abdominal CT-scans.

Key Findings:
  • Internal herniation is a common complication post-RYGB, with incidences ranging from 1 to 12%, highlighting the need for accurate diagnosis.
  • Diagnostic laparoscopy often yields negative results for internal herniation, exposing patients to unnecessary procedures, with rates of negative findings between 28-53%.
  • Structured assessment of CT-scans improves diagnostic accuracy compared to free text reporting, reducing false positives and negatives.
Interpretation:

A structured approach to CT-scan interpretation may enhance the diagnosis of internal herniation, potentially reducing unnecessary laparoscopies by providing clearer diagnostic criteria.

Limitations:
  • The study is retrospective and conducted at a single center, which may limit generalizability and introduce selection bias.
  • Interobserver agreement for CT-signs varied, indicating potential inconsistencies in interpretation that could affect the reliability of the scoring system.
Conclusion:

Developing a structured prediction score for internal herniation based on CT-signs could significantly improve diagnostic accuracy and patient outcomes post-RYGB, ultimately reducing the burden of unnecessary surgical interventions.

Original Source(s)

Optimal Use of Computed Tomography in Diagnosing Internal Herniation After Roux-en-Y Gastric Bypass: A Proposition for the Application of a Radiological Prediction Score

  • by Lilian L. van Hogezand, Lucas Goense, Erik J.R.J. van der Hoeven, Charlotte J. Tutein Nolthenius, Niek van Oorschot, Luigi A.M.J.G. van Riel, Marinus J. Wiezer, Niels A.T. Wijffels, Marijn Takkenberg, Wouter W. Te Riele, Lea M. Dijksman, Hjalmar C. van Santvoort, Wouter J.M. Derksen

  • October 18, 2025

Related Content

Quantifying the anatomical variability of the proximal femur

AI in Surgery: Debate Highlights Benefits, Gaps

Surgeons and researchers clash over whether current AI systems are ready for clinical use — and what responsible adoption would require.

The Loan Cap That Could Shrink the Doctor Pipeline

New federal limits on medical school borrowing may quietly reshape who becomes a physician—and where they practice.