Acute Gastric Dilatation Following 360-Degree Erosion of Gastric Lap Band

Jane E. Harrell, BS, Jeffrey Friedman, MD

College of Medicine (Dr Harrell) and Department of Surgery (Dr Friedman), University of Florida, Gainesville, Florida, USA.

ABSTRACT

Introduction: Gastric band erosion is a rare but serious complication after laparoscopic adjustable gastric band placement. With this complication, the band usually partially erodes into the stomach lumen, which necessitates its removal. We present 2 previously unreported cases of complete 360° erosion with acute gastric dilatation, requiring emergent removal of the eroded band.

Case Descriptions: A 51-year-old woman with a 7-year history of laparoscopic adjustable gastric band presented to the emergency department with epigastric abdominal pain, nausea, vomiting, and dysphagia. Computed tomography (CT) revealed gastric dilatation below the eroded band, and intraoperative endoscopy confirmed that the band had completely eroded into the lumen. A 76-year-old man with an 8-year history of gastric band developed acute-onset nausea and severe abdominal pain. CT revealed 360° erosion of the band with severe gastric dilatation below the eroded band, causing gastric pneumatosis and hepatic portal venous gas. Management of both cases involved removal of the gastric band through a gastrotomy.

Discussion: Gastric band erosion of 360° with concurrent acute gastric dilatation requires immediate removal of the eroded band, to prevent the severe complication of gastric necrosis.

Key Words: Bariatric surgery, Erosion of lap band, Lap band, Lap band complications.

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