Case Report of Successful Medical Management of Progressive Gastric Band Penetration-to-Perforation After Band Insertion at Bariatric Surgery: Documentation by 12 Serial EGDs During 50 months of Observation.

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Gastric band (GB) surgery is a relatively popular form of bariatric surgery for morbid obesity, in which a flexible band is wrapped around and constricts the proximal stomach, just below the gastroesophageal junction, to promote weight loss via reduced gastric capacity and enhanced early satiety. Gastric erosion is a major complication of GB surgery, in which the GB erodes through the serosal surface of the stomach. Little is known about endoscopic progression of GB erosion because patients usually undergo only one diagnostic esophagogastroduodenoscopy (EGD). A novel case is reported of gradual penetration-to-perforation-to-passage-per-rectum of a non-adjustable GB, documented by 12 gastroenterology office visits and 12 serial EGDs during 50 months of medical observation. This progression is remarkable for only mild symptoms, successful non-surgical management of slow gastric transection, and spontaneous re-anastomosis after gastric transection without endoscopically evident gastric injury.


American College of Gastroenterology Annual Meeting, Orlando, FL, October 13-18, 2017.