Dilated esophagus due to tight gastric band

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Reflux after drinking with associated distress. Neck is swollen.

Patient Data

Age: 70 years
Gender: Female

Tubing in the upper abdomen in keeping with a gastric band. The esophagus is markedly distended, tortuous and air-filled, especially the cervical esophagus. There is some atelectasis in both lungs bases, more on the left side. No pleural effusion. The heart size is within normal limits for projection.

Case Discussion

Extensive esophageal dilatation in the presence of a gastric band suggests the gastric band may be too tight or malfunctioning and this could be further assessed with a fluoroscopic swallow study.

The patient went back to the private surgeon who performed the gastric band surgery. Case follow up via verbal communication with the surgeon:

  • band too tight as demonstrated on barium swallow study
  • volume of fluid in band reduced
  • still no resolution of symptoms or esophageal dilatation
  • band removed

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