Abstract：
BACKGROUND: Abdominal pain after bariatric surgery (BS) is frequently observed. Despite numerous diagnostic tests, the cause of abdominal pain is not always found.
OBJECTIVE: To quantify type and number of diagnostic tests performed in patients with abdominal pain after BS and evaluate the burden and their yield in the diagnostic process.
METHODS: A bariatric center in the Netherlands.
METHODS: In this prospective study, we included patients who presented with abdominal pain after BS between December 1, 2020, and December 1, 2021. All diagnostic tests and reoperations performed during one episode of abdominal pain were scored using a standardized protocol.
RESULTS: A total of 441 patients were included; 401 (90.9%) were female, median time after BS was 37.0 months (IQR, 11.0-66.0) and mean percentage total weight loss was 31.41 (SD, 10.53). In total, 715 diagnostic tests were performed, of which 355 were abdominal CT scans, 155 were ultrasounds, and 106 were gastroscopies. These tests yielded a possible explanation for the pain in 40.2% of CT scans, 45.3% of ultrasounds, and 34.7% of gastroscopies. The diagnoses of internal herniation, ileus, and nephrolithiasis generally required only 1 diagnostic test, whereas patients with anterior cutaneous nerve entrapment syndrome, irritable bowel syndrome, and constipation required several tests before diagnosis. Even after several negative tests, a diagnosis was still found in the subsequent test: 86.7% of patients with 5 or more tests had a definitive diagnoses. Reoperations were performed in 37.2% of patients.
CONCLUSIONS: The diagnostic burden in patients with abdominal pain following BS is high. The most frequently performed diagnostic test is an abdominal CT scan, yielding the highest number of diagnoses in these patients.
OBJECTIVE: To quantify type and number of diagnostic tests performed in patients with abdominal pain after BS and evaluate the burden and their yield in the diagnostic process.
METHODS: A bariatric center in the Netherlands.
METHODS: In this prospective study, we included patients who presented with abdominal pain after BS between December 1, 2020, and December 1, 2021. All diagnostic tests and reoperations performed during one episode of abdominal pain were scored using a standardized protocol.
RESULTS: A total of 441 patients were included; 401 (90.9%) were female, median time after BS was 37.0 months (IQR, 11.0-66.0) and mean percentage total weight loss was 31.41 (SD, 10.53). In total, 715 diagnostic tests were performed, of which 355 were abdominal CT scans, 155 were ultrasounds, and 106 were gastroscopies. These tests yielded a possible explanation for the pain in 40.2% of CT scans, 45.3% of ultrasounds, and 34.7% of gastroscopies. The diagnoses of internal herniation, ileus, and nephrolithiasis generally required only 1 diagnostic test, whereas patients with anterior cutaneous nerve entrapment syndrome, irritable bowel syndrome, and constipation required several tests before diagnosis. Even after several negative tests, a diagnosis was still found in the subsequent test: 86.7% of patients with 5 or more tests had a definitive diagnoses. Reoperations were performed in 37.2% of patients.
CONCLUSIONS: The diagnostic burden in patients with abdominal pain following BS is high. The most frequently performed diagnostic test is an abdominal CT scan, yielding the highest number of diagnoses in these patients.
摘要：
背景：经常观察到减肥手术（BS）后的腹痛。尽管有许多诊断测试，腹部疼痛的原因并不总是被发现。
目的：量化BS后腹痛患者进行的诊断测试的类型和数量，并评估诊断过程中的负担及其产量。
方法：荷兰一家减肥中心。
方法：在这项前瞻性研究中，我们纳入了2020年12月1日至2021年12月1日期间BS后出现腹痛的患者.使用标准化方案对在一次腹痛发作期间进行的所有诊断测试和再次手术进行评分。
结果：共纳入441例患者；401例（90.9%）为女性，BS后的中位时间为37.0个月(IQR，11.0-66.0)，平均总体重减轻百分比为31.41(SD，10.53).总的来说,进行了715次诊断测试，其中355项是腹部CT扫描，155是超声波，106次是胃镜检查。这些测试为40.2%的CT扫描中的疼痛提供了可能的解释，45.3％的超声波，以及34.7%的胃镜检查。内部疝的诊断，肠梗阻,和肾结石通常只需要一个诊断测试，而患有前皮神经卡压综合征的患者，肠易激综合征,便秘在诊断前需要多次检查。即使经过几次阴性测试，在随后的测试中仍然发现了诊断:接受5次或更多次测试的患者中有86.7%的患者有明确的诊断.37.2%的患者再次手术。
结论：BS后腹痛患者的诊断负担很高。最常用的诊断检查是腹部CT扫描,这些患者的诊断次数最多。
目的：量化BS后腹痛患者进行的诊断测试的类型和数量，并评估诊断过程中的负担及其产量。
方法：荷兰一家减肥中心。
方法：在这项前瞻性研究中，我们纳入了2020年12月1日至2021年12月1日期间BS后出现腹痛的患者.使用标准化方案对在一次腹痛发作期间进行的所有诊断测试和再次手术进行评分。
结果：共纳入441例患者；401例（90.9%）为女性，BS后的中位时间为37.0个月(IQR，11.0-66.0)，平均总体重减轻百分比为31.41(SD，10.53).总的来说,进行了715次诊断测试，其中355项是腹部CT扫描，155是超声波，106次是胃镜检查。这些测试为40.2%的CT扫描中的疼痛提供了可能的解释，45.3％的超声波，以及34.7%的胃镜检查。内部疝的诊断，肠梗阻,和肾结石通常只需要一个诊断测试，而患有前皮神经卡压综合征的患者，肠易激综合征,便秘在诊断前需要多次检查。即使经过几次阴性测试，在随后的测试中仍然发现了诊断:接受5次或更多次测试的患者中有86.7%的患者有明确的诊断.37.2%的患者再次手术。
结论：BS后腹痛患者的诊断负担很高。最常用的诊断检查是腹部CT扫描,这些患者的诊断次数最多。
