Gastric Occlusion due to the Intragastric Balloon Displacement in the Era of Coronavirus Disease-19 (COVID-19) Pandemic,
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LETTER TO THE EDITOR
Gastric Occlusion due to the Intragastric Balloon Displacement in the Era of Coronavirus Disease-19 (COVID-19) Pandemic, Operative Management: a Case Report Giuliano Riccardo Sarro 1 & Virginia Ceccarossi 1 & Elisa Arborio 1 & Marco Bindi 1 & Vincenzo Tripodi 1 & Umberto Rivolta 1 & Giuseppe Ursini 2 & Matteo Marconi 1 Received: 26 April 2020 / Revised: 26 May 2020 / Accepted: 28 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Introduction Obesity is one of the most widespread health problems worldwide. Intragastric balloons (IGB) are considered safer, miniinvasive treatments to induce weight loss [1, 2] in obese patients with a body mass index (BMI) > 30. As other miniinvasive surgical treatments, the use of IGB is not free from possible complications. We report a case of a patient who underwent IGB removal due to bowel obstruction in the era of SARS-CoV-2 pandemic.
Case Report We present a case of a 44-year-old woman who underwent Bioenteric Intragastric Balloon (BIB) removal because of its migration into the gastric antrum, causing occlusion with recurrent vomiting, in the era of SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) pandemic [3]. The patient had undergone BIB positioning for obesity 5 months earlier (October 2019). Early and late postoperative periods were uneventful. The patient had a past history of
hypothyroidism due to Hashimoto disease. The body weight at the moment of the BIB placement was 74 kg with a BMI of 30.5 (maximum BMI was 34); she achieved a 10-kg weight loss, reaching a BMI of 26.5. In March 2020, she was admitted to Emergency Department (ED) as the subject was unable to ingest any solids or liquids for 2 weeks and vomited repeatedly. She was hemodynamically stable and had fever and cough. Neither leucocytosis nor C-reactive protein (CRP) increase was shown from blood tests, but an initial electrolyte disorder was detected. She complained a moderate abdominal pain and a palpable mass was detected in right upper quadrant during physical examination. Suspecting a BIB-related complication, she underwent chest X-rays showing a single airfluid level in the left upper quadrant and an early stage interstitial lung involvement. Abdominal ultrasonography revealed the dislocation of the device into the gastric antrum with a lot of gastric contents into the fundus and the gastric body (Fig. 1). Thus, she was admitted in surgery ward. Before the hospitalization, in this particular historical context, the patient was submitted to naso-pharyngeal test for SARS-CoV-2 disease, which resulted positive. Considering her clinical conditions and symptoms conditioning the hospitalization, the
* Virginia Ceccarossi [email protected]
Umberto Rivolta [email protected] Giuseppe Ursini [email protected]
Giuliano Riccardo Sarro [email protected]
Matteo Marconi [email protected]
Elisa Arborio [email protected] 1
General and Oncology Surgery Department, Ospedale Giuseppe Fornaro
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