Gastric Ulceration Due To Intragastric Balloon Insertion In a Patient With Vertical Banded Gastroplasty

Obesity in Europe is a medical crisis: data reveals that 59% of adults suffer either from overweight or obesity [1]. In cases in which lifestyle modification and anti-obesity medication are not sufficient, using a minimally invasive approach such as intragastric balloon (IGB) insertion could be recommended. However, this technique is not risk-free. Specially in cases with previous gastric surgery, IGB is considered an absolute contraidication [2] [3], although there is no unanimous consensus [4]. We report a case of a gastric ulcer developed secondary to the use of an IGB in a patient with previous gastric surgery. The patient underwent vertical banded gastroplasty in her youth as treatment for grade III obesity. Initially she lost weight, but she regained it with the years. She decided to undergo IGB. She failed to report her past surgical history. The IGB was swallowed as a capsule and then filled with 500 ml of saline. After instillation the patient had a syncope so the IGB was immediately removed. After 24 h in observation she was discharged in a stable condition. Two weeks later the patient started with hematemesis and abdominal pain so she was referred to our hospital. Urgent upper endoscopy showed a big clot in the pouch zone which was partially removed, showing a 35 mm ulcer Forrest class III and a 15 mm ulcer Forrest class IIa. Two clips were placed on the 15 mm ulcer. She was discharged after a five-day hospital stay. These ulcers probably developed secondary to mechanical compression of the pouch mucosa by the gastric balloon. The possibility of a previous gastric surgery should be investigated in every pacient considering IGB, specially in cases in which IGB is not placed endoscopically.

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Artikel online veröffentlicht:
27. März 2025

• References

• 1 WHO European Regional Obesity Report 2022. Copenhagen: WHO Regional Office for Europe; 2022. Licence: CC BY-NC-SA 3.0 IGO
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