Intragastric balloon migration with small bowel obstruction

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Abdominal pain and vomiting.

Patient Data

Age: 35 years
Gender: Female

Multiple air-fluid levels of small bowel shadows, suggestive of small bowel obstruction.

The gastric balloon marker is seen near midline at the level of L4-5 disc, suggestive of migration.

Collapsed bariatric gastric balloon that is located at the ileum with proximal small bowel dilatation reflecting small bowel obstruction.

Mild free fluid at the pelvis.

Two years previously

x-ray

Plain x-ray of the abdomen 2 years previously shows normal location of intragastric balloon marker at left hypochondrial region.

Two and half years previously

x-ray

Plain x-ray of the chest two and half years previously shows normal position of intragastric balloon marker at left hypochondrial region.

Case Discussion

The bariatric intragastric balloon had spontaneously deflated and migrated into the small bowel, causing small bowel obstruction. Generally, intragastric balloon should be removed after 6 months to avoid complications. The lack of follow up for two years, in this case, led to balloon deflation and migration causing small bowel obstruction. The patient was prepared for surgical removal.

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