Leak after gastric bypass on upper gastrointestinal series

Early clinical symptoms of a leak after bariatric surgery are subtle and require clinical vigilance for signs such as low-grade fevers, respiratory compromise, or unexplained tachycardia. A leak (arrow) may be radiographically confirmed by an upper gastrointestinal series (as shown here) or contrast computed tomography (CT). If a leak is suspected clinically, emergency surgical exploration should be performed even if the imaging is negative, given the rapid progression to sepsis in patients with severe obesity and comorbidities.