As adjustable gastric banding surgery becomes common, more patients are presenting to the emergency department with complications of the procedure, especially those resulting from slippage of the gastric band. “Because the consequences of slippage may require acute surgical intervention, it is imperative that the radiologist is familiar with the surgical technique to correctly position the band and the appearances of a gastric band when correctly and incorrectly positioned,” said Sabrina Pieroni, M.D., from Boston Medical Center (Boston, MA, USA), and lead author of the study, which was published in the July 2010 issue of the American Journal of Roentgenology (AJR).

Researchers reviewed the radiologic findings in 55 consecutive patients who underwent laparoscopic gastric banding. Gastric band slippage was diagnosed and surgically confirmed in four patients. “In all four patients with surgically proven gastric band slippage, the initial abdominal X-ray showed an O-shaped configuration of the gastric band, which we have termed the ‘O’ sign,” said Dr. Pieroni. In each case, the O-shaped configuration of the band was a change from its rectangular appearance when in the proper position.

“As adjustable banding is increasingly used, more patients will present to the emergency department with complications of the procedure, particularly complications from band slippage,” said Dr. Pieroni. “Identification of the O sign on radiography can potentially aid the radiologist, surgeon, or emergency department physician in the early detection of gastric band slippage and appropriate patient triage.”

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