Gastric outlet obstruction due to gastric balloon

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Underwent insertion of gastric balloon for weight loss a few days earlier. Presents with acute onset of vomiting.

Patient Data

Age: 35 years
Gender: Female

The stomach is grossly distended with fluid and air, with a normal caliber duodenum and remaining small bowel. The balloon can be appreciated in the antrum, causing obstruction of the stomach due to likely impaction in the pre-pyloric region. An air-fluid level is present within the balloon, and some density is noted in its wall. No free air or free fluid. No other abnormalities.

Case Discussion

One of the known complications of gastric balloons is gastric outlet obstruction due to impaction of the balloon at the exit of the stomach. This necessitated an emergency endoscopic removal of the balloon to relieve the obstruction. Other complications include spontaneous rupture, and then passage along the small bowel leading to eventual small bowel obstruction.

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