Gastric Necrosis: A Possible Complication of the Use of the Intragastric Balloon in a Patient Previously Submitted to Ni
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CASE REPORT
Gastric Necrosis: A Possible Complication of the Use of the Intragastric Balloon in a Patient Previously Submitted to Nissen Fundoplication José Ignacio Rodríguez-Hermosa & Josep Roig-García & Jordi Gironès-Vilà & Bartomeu Ruiz-Feliú & Patricia Ortiz-Ballujera & María Rosa Ortiz-Durán & Antoni Codina-Cazador
Received: 2 February 2009 / Accepted: 27 April 2009 / Published online: 9 June 2009 # Springer Science + Business Media, LLC 2009
Abstract The temporary use of the bioenterics intragastric balloon in morbid obesity is increasing worldwide. Generally, this is an effective procedure that helps bring about satisfactory weight loss and improvement in comorbidities after 6 months. However, in some cases, it causes complications such as acute abdomen due to gastric perforation and even death. We describe the case of a type II obese female (weight, 88 kg; body mass index, 35.2 kg/m2) who underwent emergency surgery for gastric necrosis caused by bioenterics intragastric balloon; the patient required total gastrectomy and intensive care. Keywords Obesity . Morbid obesity . Intragastric balloon . Gastric perforation
J. I. Rodríguez-Hermosa (*) : J. Roig-García : J. Gironès-Vilà : B. Ruiz-Feliú : A. Codina-Cazador Department of Surgery, University Hospital Dr Josep Trueta, Avda. França s/n, 17007 Girona, Spain e-mail: [email protected] J. I. Rodríguez-Hermosa : J. Roig-García : J. Gironès-Vilà : B. Ruiz-Feliú Bariatric Surgery Section, University Hospital Dr Josep Trueta, Girona, Spain
Introduction Obesity is considered “the epidemic of the twenty-first century”; it is estimated that there will be approximately 2.3 billion overweight people and more than 700 million obese people in 2015. Obesity has a strong impact on the quality of life, morbimortality, and healthcare expenditures [1, 2]. Treatment options for obesity include hypocaloric diets, lifestyle changes, drug therapy, intragastric balloon, and bariatric surgery [3]. The intragastric balloon was first used to bring about the sensation of satiation in 1982 [4]. Intragastric balloons are currently indicated (a) for obese patients who are refractory to dietary treatment, (b) as a temporary preoperative measure to promote weight loss and thus reduce the risk of bariatric surgery, and (c) in severely obese patients who are not candidates for bariatric surgery [3, 5]. Gastric perforation after intragastric balloon placement is uncommon; however, this complication leads to high morbimortality [6]. Obese patients with intestinal perforations are more difficult to diagnose; thus, diagnosis and treatment are often delayed [7]. We present an unusual case of massive gastric necrosis resulting from endoscopic intragastric balloon placement in a woman with type II obesity and severe associated diseases.
P. Ortiz-Ballujera Intensive Care Unit, University Hospital Dr Josep Trueta, Girona, Spain
Case Report
M. R. Ortiz-Durán Department of Histophatology, University Hospital Dr Josep Trueta, Girona, Spain
A 53-year-old woman, obese since adolescence, who had
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