Citation, DOI, disclosures and article data
Citation:
Sheikh Z, Elfeky M, Macori F, et al. Gastric band slippage. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-45659
Gastric band slippage is a late complication of laparoscopic gastric banding surgery performed for obesity. It is reported to occur in 4-13% of cases 1-3.
It can occur in either an anterior or posterior direction.
Clinical presentation
Patients can present with cessation of weight loss, severe gastro-esophageal reflux, and nocturnal vomiting. If there is associated pouch dilation there may also by symptoms of obstruction.
Radiographic features
The diagnosis can be challenging as pouch slippage may occur transiently with progressive filling of the gastric stoma after which the band resumes a normal position.
Plain radiograph
the 'O' sign is seen on AP views which represents the gastric band being visible end on. This is highly suggestive of posterior band slippage 4
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Phi angle: the angle between the vertical axis and gastric band in AP view 6
Fluoroscopy
This shows abnormal band position as well as a stoma cavity with a maximal diameter exceeding 4 cm representing associated pouch dilation.
CT
This demonstrates herniation of the stomach through the gastric band. It may also demonstrate eccentric pouch dilation.
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4. Pieroni S, Sommer EA, Hito R, Burch M, Tkacz JN. The "O" sign, a simple and helpful tool in the diagnosis of laparoscopic adjustable gastric band slippage. (2010) AJR. American journal of roentgenology. 195 (1): 137-41. doi:10.2214/AJR.09.3933 - Pubmed
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