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Malpositioned gastric band

Case contributed by Derek Smith
Diagnosis certain


Severe epigastric pain and vomiting - perforation?

Patient Data

Age: 65 years
Gender: Female

CXR and AXR demonstrating slipped / malpositioned gastric band. The band lies at about 100-110° instead of the acceptable phi angle (4-58°).

No proximal pouch dilatation. No perforation.

Case Discussion

Assessment of gastric band position is important in all studies, especially those presenting with epigastric pain. The phi angle is measured along the long axis of the band and the vertical line of the vertebral column, normally sitting between 4-58°, sitting around the gastric cardia.

It is important to also assess for perforation or obstruction. Fluoroscopy can be used to further assess band function.

These can be manipulated and repositioned either under fluoroscopic guidance or direct visualization.

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