Migration of the Gastric Band to the Colon and Excretion Seven Years After Placement
Mario Alberto Almanza Reyes, MD, Yajaira Ríos Hernández, MD, José Román Chávez Méndez, MPH, María De Los Ángeles Leal Ávila, MD, PD, Alejandra Núñez-Sánchez, MS, Ahmed Ali Asadi González, PhD, Leslie Patrón Romero, MD, CG, Horacio Eusebio Almanza Reyes, PhD
Department of Bariatric Surgery, Grand View Hospital, Tijuana Baja California, México (Dr Reyes). School of Medicine, University Studies Center Xochicalco, Tijuana Baja California, Mexico (Dr Hernández). Faculty of Medicine and Psychology of the Autonomous University of Baja California. Campus Tijuana, Mexico (Drs Ávila, González, Romero, and Reyes; Mr. Méndez; Ms Sánchez).
Introduction: Intragastric band migration (IGBM) is a rare but serious late complication of laparoscopic adjustable gastric banding (LAGB). It is the result of a complete transmural migration with a simultaneous effective resolution of the gastric wall perforation. In some rare cases, the band can migrate distally into the jejunum, ileum, colon, and rectum, causing mechanical obstruction or intestinal perforation.
Case Descriptions: We present a case of a 58-year-old woman with an unusual and infrequent complication of gastric band erosion through the stomach, and its subsequent migration to the colon and spontaneous excretion per rectum 7 years after its placement.
Discussion: IGBM can be completely asymptomatic. If the patient presents with prolonged epigastric pain or regains weight, diagnostic studies should be performed to prevent more severe associated complications. This situation went unnoticed by the patient who reported only general symptoms, and did not reach the stage of severe complication, such as mechanical obstruction and intestinal perforation. In the literature, reports of distal migration to the intestine are even rarer, and migration to the sigmoid colon and rectum, as in our patient, is extremely rare.
Key Words: Band erosion, Gastric band complication, Laparoscopic gastric banding, Migration.