Rao Anil D, Ramalingam Ganesh
Department of Surgery, Alexandra Hospital, Singapore.
Obes Surg. 2006 Dec;16(12):1675-8. doi: 10.1381/096089206779319518.
Laparoscopic adjustable gastric banding (LAGB) has become a common bariatric operation, because of its safety, laparoscopic friendliness, acceptable weight loss and absence of long-term adverse nutritional sequelae. Gastric erosion is one of the troublesome complications of gastric banding. The etiology and presentation of erosion remain obscure. We present a patient who complained of persistent pain 6 months after gastric banding. Endoscopy revealed the band to be normally situated, which was also confirmed on upper GI imaging. Despite this, the patient subsequently presented with massive GI hemorrhage and circulatory collapse due to erosion, which necessitated emergency laparotomy with retrieval of the band from within the gastric lumen. This case highlights the possible urgent presentation of erosion after gastric banding, which was hitherto considered to be a more insidious complication. A high index of clinical suspicion remains the mainstay of diagnosis.
腹腔镜可调节胃束带术（LAGB）已成为一种常见的减肥手术，因其安全性高、对腹腔镜手术友好、减重效果可接受且无长期不良营养后遗症。胃糜烂是胃束带术令人困扰的并发症之一。糜烂的病因和表现仍不明确。我们报告一名患者，在胃束带术后6个月抱怨持续疼痛。内镜检查显示束带位置正常，上消化道造影也证实了这一点。尽管如此，该患者随后因糜烂出现大量胃肠道出血和循环衰竭，需要紧急剖腹手术从胃腔内取出束带。本病例突出了胃束带术后糜烂可能的紧急表现，而糜烂迄今被认为是一种更隐匿的并发症。高度的临床怀疑仍然是诊断的主要依据。
