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Il Giornale Italiano di Radiologia Medica 2019 Luglio-Agosto;6(4):309-15

DOI: 10.23736/S2283-8376.19.00214-6

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

CT diagnosis of a rare case of mechanic bowel obstruction following late dislocation of a gastric band

Margherita TRINCI 1, Carola PALLA 2 , Michele GALLUZZO 1, Riccardo FERRARI 1, Viola VALENTINI 1, Bruno TRUOSOLO 3, Vittorio MIELE 4

1 Unit of Diagnostic Imaging 1 Emergency-Urgency, Department of Emergency, Acceptance and Clinic Area, S. Camillo-Forlanini Hospital, Rome, Italy; 2 Unit of Radiology A, Department of Radiologic, Oncologic, Anatomopathologic Sciences, Policlinico Umberto I Hospital, Sapienza University, Rome, Italy; 3 Unit of General and Urgency Surgery, Department of Emergency, Acceptance and Clinic Area, S. Camillo-Forlanini Hospital, Rome, Italy; 4 Department of Diagnostic Imaging, Careggi University Hospital, Florence, Italy


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Laparoscopic adjustable gastric banding (LAGB) represents an effective and safe treatment for morbid obesity. Early complications associated with this technique include perioperative perforations, bleeding and infection. Late complications most frequently reported are the slippage of the band, the erosion of the gastric wall and the migration of the band. We reported a case of band migration with subsequent bowel obstruction, that represents a rare but serious complication. A 67 years old woman who had undergone LAGB 16 years earlier was referred to our hospital with a 2 days history of abdominal pain and vomiting. CT examination revealed that the band was completely migrated into the gastric lumen and had reached the jejunum, causing a mechanical bowel obstruction. Using a laparotomic approach, the band was removed by transversal enterotomy, without any complication. Although the erosion of gastric wall is a complication usually described during the first 3 years after surgery, in the case reported it has occurred later. However, the patient had never experienced epigastric pain during the previous years and she had not informed any doctor about her weight regain, since she did not undergo regular follow-up examination after surgery. Gastric wall erosion and band migration should be always ruled out in patients who underwent LAGB because of the possibility of severe complications like bowel obstruction that can occur even when nonspecific abdominal symptoms are referred. However international guidelines on technique and timing of follow-up for band dislocation are not still present.


KEY WORDS: Obesity, morbid; Surgical procedures, operative; Diagnostic imaging

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