Evaluation of the postoperative stomach and duodenum.

Patients who undergo a gastric or duodenal operation present challenging problems to the physician. Currently, gastric or duodenal operations are performed to correct peptic ulcer disease and its complications, resect benign or malignant masses, and control obesity. Indications for surgery in patients with peptic ulcer disease include hemorrhage, perforation, obstruction, ulcer intractability, and the inability to exclude malignancy in a gastric ulcer. Neoplasms of the stomach and duodenum require resection, depending on their benign or malignant nature, their location, the extent of disease, and the underlying physiologic status of the patient. Most clinically significant gastroduodenal masses are malignant and require formal anatomic resection, usually with distal or total gastrectomy. Stapling procedures have been shown to be effective in reducing excess body weight with creation of a small gastric pouch to restrict the outlet and cause early satiety, decreased caloric intake, and weight loss. Reliable radiologic findings depend on a thorough understanding of the complex anatomic and physiologic alterations that occur after surgery and familiarity with appropriate techniques of examination. With this background, complications unique to the surgical procedure as well as general complications found in all postoperative patients with be detected quickly and accurately.