Gastric Banding Causing Adnexal Entrapment During Pregnancy

Zvi Vaknin, MD, Hasan Kais, MD, Noga Fuchs, MD, Sharon Berger, MD, Moty Pansky, MD, Noam Smorgick, MD, Msc

Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Beer Yaakov, Israel (Drs. Vaknin, Fuchs, Berger, Pansky; Smorgick). Department of General Surgery B, Assaf Harofe Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Beer Yaakov, Israel (Dr. Kais).

ABSTRACT

Introduction: Laparoscopic adjustable gastric banding (LAGB) is commonly used for the management of morbid obesity in women of reproductive age. This surgery was found to be safe and well tolerated during pregnancy, with a lower incidence of gestational diabetes and maternal hypertension than was found in control subjects. The most common complications of LABG include gastric perforation, band slippage, and port disconnection. We present an unusual complication of LABG during pregnancy.

Case Description: The patient is a 34-year-old pregnant woman who underwent LABG 3 years prior to her pregnancy and presented at 14 weeks’ gestation with acute left lower quadrant abdominal pain. Laparoscopy was performed for suspected adnexal torsion (based on clinical presentation and sonographic findings), revealing an entrapment of the left adnexum by the connecting tube of the LAGB device. The left adnexum was released with no residual complications.

Discussion: This complication, although rare, should be considered during early pregnancy.Key Words: Laparoscopic adjustable gastric banding, Pregnancy, adnexal torsion.

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