Gastric balloon causing small bowel obstruction: treatment by double-balloon enteroscopy
22 March 2013 (online)
A 32-year-old woman was referred to our emergency department because of abdominal pain and vomiting. She had received a gastric balloon in an outpatient clinic 5 years previously to treat obesity, but had not attended follow-up appointments. Emergency computed tomography showed a partially deflated gastric balloon ([Fig. 1], arrow) in the mid part of the jejunum with proximal dilatation of the small bowel loops consistent with ileus.
To remove the gastric balloon from the jejunum, the patient was offered peroral double-balloon enteroscopy under conscious sedation. The gastric balloon was found at an insertion depth of 180 cm ([Fig. 2 a]). To empty the methylene-blue-containing saline out of the gastric balloon, a standard injection needle was used to perforate the silicone wall ([Fig. 2 b]). The deflated gastric balloon was folded up using a large polypectomy snare and was removed ([Fig. 2 c]). The symptoms resolved quickly and the patient was discharged the next day.
Insertion of gastric balloons is performed as a temporary measure for weight loss . If a gastric balloon remains longer than scheduled, it may deflate spontaneously and cause obstruction by entering the bowel. Similar cases have been treated by surgery    . However, double-balloon enteroscopy seems a promising method to treat bowel obstruction caused by partially deflated gastric balloons.
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