Managing bariatric patients in a children's hospital: radiologic considerations and limitations

As the increasing prevalence of pediatric obesity and its associated risks gain national attention, adolescent bariatric surgery is gradually gaining acceptance as a viable weight loss tool for some severely obese adolescents. Obese patients often exceed the capacity limits of most radiological devices used for imaging. Because the radiological evaluation often plays a crucial role in the management of these patients, it is important for pediatric surgeons and radiologists to be aware of the special challenges and alternative algorithms for radiological evaluation. This review outlines and illustrates these considerations and limitations. Herein the authors discuss these topics within the context of characteristic bariatric patient profiles and the Roux-en-Y gastric bypass procedure, currently the authors' standard operative approach.