Migrated gastric balloon causing small bowel obstruction

Case contributed by Talal F M Abdullah
Diagnosis certain

Presentation

Complaining of abdominal pain, vomiting and constipation for 3 days. Abdominal distention and decrease bowel sounds. H/O gastric balloon insertion last year.

Patient Data

Age: 40 years
Gender: Male

Multiple small bowel air-fluid levels keeping with small bowel obstruction. Note the dense opacity projected over the fourth left lumbar transverse process.

CT abdomen demonstrates distended small bowel loops and congested mesentery; the so-called balloons on string sign. Transition point is noted at the luminal foreign body at the mid-ileal loops with distal collapse and proximal bowel dilatation. Mild free pelvic fluid and peritoneal thickening and mesenteric fat stranding.

NG tube and Foley's tube noted in situ.

Case Discussion

Fracture and subsequent migration of a gastric balloon resulted in luminal occlusion of the mid-ileal loops and subsequent small bowel obstruction. The balloon was scheduled to be removed six months following placement, but this wasn't done. The patient went for a laparotomy.

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