Small bowel obstruction secondary to gastric band erosion and migration to jejunum

Matt Strickland, MD, BASc, Dan Abramowitz, MD, John Hagen, MD, David Starr, MD. University of Toronto.

This video illustrates the management of a partial small bowel obstruction secondary to gastric band erosion and migration to the jejunum. This is a rare complication of laparoscopic gastric banding.

A 53-year-old female presented five years after insertion of a laparoscopic gastric band with vomiting, bloating, and abdominal pain. This was on a background of weight regain and chronic esophagitis that had necessitated deflation of her band. Abdominal imaging revealed that the band had eroded intraluminally and had migrated to the jejunum. The patient was tachycardic but otherwise stable.

Exploratory laparoscopy was performed and this revealed dense adhesions near the gastroesophageal junction. The band was located in the proximal esophagus, an enterotomy was made, and the band was removed. The defect was closed primarily.
exploratory laparoscopy identified a chronic, well-healed erosion of the gastric band through the gastroesophageal junction with subsequent intraluminal migration of the band into the jejunum resulting in a partial small bowel obstruction.

The history, etiology, presentation, and basic demographics of gastric band erosion are discussed.

This video shows that laparoscopic management of a partial small bowel obstruction from migrated, eroded gastric band is a safe and feasible approach.

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