Abdominal CT is an important tool in diagnosing internal herniation, with a high specificity and a high negative predictive value.

• Computed tomography is useful to diagnose internal herniation(IH) after gastric bypass surgery • Ten signs are described to improve CT diagnosis of IH • Systematically reviewing CT scans improves specificity • There is no difference in experience levels when using these ten signs.

Objectives To confirm that structured reporting of CT scans using ten signs in clinical practice leads to a better accuracy in diagnosing internal herniation (IH) after gastric bypass surgery, compared with free-text reporting.

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