Case reportGastric band erosion and intraluminal migration leading to biliary and small bowel obstruction: case report and discussion
Section snippets
Case report
A 45-year-old woman who had undergone open vertical banded gastroplasty with placement of a Kuzmak adjustable gastric band at an outside institution 15 years earlier was referred to us with a 5-month history of recurrent epigastric abdominal pain, nausea, and emesis. She had previously been hospitalized on multiple occasions with a presumptive diagnosis of acute-on-chronic alcoholic pancreatitis. Abdominal ultrasonography revealed mild biliary duct dilation with a maximal common bile duct
Discussion
Bariatric surgery is widely recognized as an effective treatment of morbid obesity. Laparoscopic adjustable gastric banding was first described in 1992 and is currently the most frequently performed bariatric procedure in Europe, Australia, and the United States [7].
Long-term complications, which have included stenosis of the stoma, severe food intolerance, and disruption of the staple line, can occur after vertical banded gastroplasty [1]. Rare complications after laparoscopic adjustable
Conclusion
After adjustable silicone gastric banding, rare complications such as band erosion and subsequent migration, resulting in small bowel and biliary obstruction, can occur. A high index of suspicion should always be maintained, because the clinical presentation can vary and can often be confused with other diagnoses. Although the exact etiology of such late presentation is not completely understood, multifactorial causes cannot be ruled out. After establishing the diagnosis, the removal of the
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
References (12)
- et al.
Prospective evaluation and 7-year follow-up of Swedish gastric banding in adults with extreme obesity
J Gastrointest Surg
(2007) - et al.
US experience with the LAP-BAND system
Am J Surg
(2002) - et al.
Small bowel obstruction secondary to intragastric erosion and migration of a gastric band
J Gastrointest Surg
(2008) - et al.
Small bowel obstruction secondary to intragastric erosion and migration of a gastric band
J Gastrointest Surg
(2008) - et al.
Conservative management of intragastric migration of Swedish adjustable gastric band by endoscopic retrieval
Gastrointest Endosc
(2001) - et al.
Vertical banded gastroplasty: long term results comparing three different techniques
Obes Surg
(2000)