Small bowel obstruction due to endoluminal migration of a fractured gastric band
Presentation
Acute abdominal pain. History of gastric band surgery over a decade ago. ? bowel perforation, adhesions
Patient Data
Lungs and pleural spaces are clear. Mediastinum is normal. No free sub diaphragmatic gas. Gastric band tubing is present but the band is absent.
There is acute small bowel obstruction. The transition point is due to the gastric band which is endoluminal and migrated from the stomach. In the stomach, the disconnected / fractured band tubing passes through the medial wall of the cardia where it has perforated through. The free end of the disconnected / fractured band tubing is in the gastric lumen. The remainder of the band tubing and port in the abdominal wall is well positioned.
Case Discussion
The patient was taken to theater and a mini laparotomy performed. The band had eroded through the small bowel wall at the point of transition and hence required a small length of bowel to be resected. At the stomach, the remaining tubing was removed without incident.
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