Pretolesi F, Camerini G, Gianetta E, Marinari G M, Scopinaro N, Derchi L E
Cattedra di Radiologia R, DICMI, Università di Genova, Italy.
Eur Radiol. 2001;11(3):412-6. doi: 10.1007/s003300000720.
The aim of this study was to analyse radiological findings in patients surgically treated for adjustable silicone gastric banding (ASGB) for morbid obesity complicated by band penetration into the gastric lumen. We reviewed the records of four patients with surgically confirmed penetration of gastric band into the gastric lumen; three had preoperative opaque meal, one only a plain abdominal film. Vomiting was the presenting symptom in two cases, whereas others had new weight gain and loss of early satiety. Two patients had normally closed bands: radiography showed that their position had changed from previous controls and the barium meal had passed out of their lumen. Two patients had an open band. One patient had the band at the duodeno-jejunal junction, and the tube connecting the band to the subcutaneous port presented a winding course suggesting the duodenum. In the other case, both plain film and barium studies failed to demonstrate with certainty the intragastric position of the band. As ASGB is becoming widely used, radiologists need to be familiar with its appearances and its complications. Band penetration into the stomach is a serious complication which needs band removal. Patients with this problem, often with non-specific symptoms and even those who are asymptomatic, are encountered during radiographic examinations requested either for gastric problems or follow-up purposes, and have to be properly diagnosed.
本研究的目的是分析接受可调节硅胶胃束带术（ASGB）治疗病态肥胖且并发束带穿透胃腔患者的影像学表现。我们回顾了4例经手术证实胃束带穿透胃腔患者的记录；3例术前行不透X线造影餐检查，1例仅行腹部平片检查。呕吐是2例患者的首发症状，而其他患者有体重增加及早饱感消失。2例患者的束带正常关闭：X线检查显示其位置与之前的对照相比发生了改变，且钡餐已通过束带腔。2例患者的束带开放。1例患者的束带位于十二指肠空肠交界处，连接束带与皮下端口的管道呈迂曲走行，提示十二指肠。在另一例患者中，平片和钡剂检查均未能确切显示束带在胃内的位置。由于ASGB的应用日益广泛，放射科医生需要熟悉其表现及并发症。束带穿透胃是一种严重并发症，需要移除束带。在因胃部问题或随访目的而进行的影像学检查中，会遇到有此问题的患者，他们通常症状不典型，甚至无症状，必须予以正确诊断。
