Obstruction as a complication of treatment with intragastric balloon for obesity

1 Klinika Chorób Wewnętrznych z Oddziałem Gastroenterologii, 5. Wojskowy Szpital Kliniczny, Kraków.
Kierownik Kliniki: prof. nadzw. dr hab. n. med. Iwon Grys
2 Klinika Gastroenterologii, Wojskowy Instytut Medyczny, Warszawa. Kierownik Kliniki: prof. dr hab. n. med. Jerzy Gil
3 Zakład Radiologii, 5. Wojskowy Szpital Kliniczny, Kraków. Kierownik Zakładu: dr n. med. Tomasz Puto
Adres do korespondencji: Dariusz Serwin, Klinika Chorób Wewnętrznych i Gastroenterologii, 5. WSzK, ul. Wrocławska 1–3, 30-901 Kraków, tel.: 601 517 840, e-mail: serwindariusz@poczta.fm
Praca finansowana ze środków własnych

Pediatr Med rodz Vol 9 Numer 4, p. 363–366
ABSTRACT

Background: Obesity is a disease of civilization, which may result in and aggravate already existing diseases. One method of weight loss is a gastric balloon – BioEnterics Intragastric Balloon (BIB). Treatment with the BIB is safe. Complications are rare. Aim: Consult doctors about the possibility of this rare and serious complication that can be treated conservatively. Description of case: Patient, 38 years old, hospitalized due to continuing strong 3 days intra-abdominal pain, nausea and vomiting. In an interview founded for over 9 months ago slimming balloon into the stomach. Imaging studies, such as abdominal X-ray and computed tomography (CT) of the abdomen and pelvis, in the left lower abdomen visualized an irregular change in the corresponding slimming balloon. In the absence of indications for emergency laparotomy, conservative treatment was used. Finally, there was a spontaneous expulsion of the balloon. An improvement of the general condition, relief of symptoms. Discuss the case: Treatment of obesity by setting the gastric balloon is a minimally invasive method of treatment. However, the effectiveness and the lack of complications are dependent on the patient’s knowledge about the possible complications of obesity and the chosen therapeutic method, a sense of the disease and the patient’s motivation to achieve the therapeutic success. Symptoms of spontaneous expulsion of the balloon are symptoms of a foreign factor in the gastrointestinal tract. In the case described, these symptoms have evolved along with the movement of the balloon for the next segments of the gastrointestinal tract. There were signs of high obstruction and intestinal colic. The exact position of the balloon in the gastrointestinal tract was possible to determine after taking CT scan of the abdomen. In the case described, a conservative method was used. This was possible thanks to the close cooperation between doctors of conservative and surgical specializations, and a careful observation of the dynamics of disease symptoms and movement of the balloon for the gastrointestinal tract. Conclusions: Because of the potential complications of intervention methods for weight reduction should be preceded by conservative methods. Selection of invasive methods of treatment should be preceded by a detailed analysis of the causes of failure of conservative treatment. Maintenance of balloon slimming timeout therapy may result in dangerous to life and health complications. If symptoms of obstruction or intestinal colic, patient with founded into the stomach slimming balloon should be observed in a hospital. In the absence of clinical signs of gastrointestinal perforation, esophagoduodenoscopy should be performed to locate the balloon in the stomach in the first instance, further radiological imaging studies locating the position of the balloon in the gut and documenting progress in its elimination. Surgical treatment should be considered if there is no progress spontaneous expulsion of the balloon.

Keywords: obesity, endoscopy, balloon slimming, complications, obstruction