Leak from stomach after removal of gastric band due to erosion
Gastric band 10 years ago. Recent pain and endoscopy revealed ulceration with band erosion. Band removed. Now has ongoing pain and raised inflammatory markers.
CT abdomen and pelvis with intravenous and oral contrast
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CT with intravenous and oral contrast (200 ml of 5% Gastrografin taken 5 minutes before image acquisition). Signs of recent surgery with surgical clips over left anterior abdominal wall close to the site of band tubing. The band has been removed. There is marked inflammatory change adjacent to the lesser curve and oral contrast has leaked into a track extending between the fundus and body of the stomach. Bibasal pleural effusions and subsegmental atelectasis.
The oral contrast delineates a track between the fundus and body of the stomach, at the site of the removed band. The inflammatory change induced by the band has led to erosive gastritis and although the band was removed, a "fistula" channel was left behind. Following a period of enteral nutrition via jejunostomy, repeat imaging and endoscopy showed no leak.