Ruptured gastric balloon

Case Discussion

This is a case of a ruptured gastric balloon in a patient who presented with bright blue urine in the last 24 hours.

Other details of the clinical presentation:

• 2 days of constipation with reduced oral intake

• presented without pain, fever, or significant gastrointestinal symptoms; denies nausea, vomiting, hematemesis, melena

• background of Intragastric Balloon insertion 12 months prior - awaiting removal

• reports removal was planned 6 months after insertion, patient was lost to follow-up

• minimal other PMHx and no medications

Clinical examination and pathology were unremarkable.

Management: endoscopic retrieval of the ruptured gastric balloon

Case studies of similar gastric balloon ruptures have occurred following delayed removal of the balloon. Accepted management is the removal of the balloon after 6 months as per manufacturer instructions.

While intragastric balloon rupture and removal can occur without significant sequelae, complications have been documented. In some cases, delayed removal and balloon rupture have led to mucosal inflammation ¹. Although late complications of gastric balloon insertion are rare, gastric perforation has been documented in one case study in a 5-year-old intragastric balloon ².

Gastric balloons contain a small volume of normal saline and methylene blue. One of the most common adverse effects of methylene blue is the bluish-green discolouration of urine ³.