Al-Subaie Saud, Al-Barjas Hamad, Al-Sabah Salman, Al-Helal Saud, Alfakharani Ashraf, Termos Salah
Department of Surgery, Amiri Hospital, Ministry of Health, Kuwait; Kuwait Association of Surgeons, Kuwait.
Department of Surgery, Amiri Hospital, Ministry of Health, Kuwait.
Int J Surg Case Rep. 2017;41:287-291. doi: 10.1016/j.ijscr.2017.10.050. Epub 2017 Nov 8.
The Elipse™ intragastric balloon (IGB) for weight loss is a swallowable capsule that is filled with 550mL of fluid and resides in the stomach for four months before being excreted from the gastrointestinal tract. Although initial data showed that use of this device is safe and free from serious complications, we report for the first time the successful management of an Elipse™ IGB-related adverse event.
A 41-year-old woman presented to our emergency department following two days of abdominal pain, vomiting, and constipation. Her medical history included four caesarean sections and insertion of the Elipse™ IGB 16 weeks prior to presentation. The patient was vitally stable at presentation and abdominal examination revealed a mildly distended abdomen. Plain X-ray revealed a small bowel obstruction (SBO), and a double contrast computed tomography scan showed a dilated small bowel with mild free fluid proximal to a transition zone at the distal jejunum. Laparoscopic enterotomy was performed just proximal to the obstruction site, and the balloon was visualized and extracted after it had been incised and emptied. The enterotomy incision was closed with an intracorporeal continuous absorbable suture. The patient's recovery was uneventful and she was discharged on postoperative day 4.
We discuss the possible etiologies of SBO following Elipse™ IGB insertion, and present a brief literature review regarding surgical and nonsurgical management options for such cases.
Although initial data showed the Elipse™ IGB to be safe, complications can occur and be managed successfully.
用于减肥的Elipse™胃内球囊（IGB）是一种可吞咽的胶囊，内部填充550毫升液体，在胃内停留四个月后从胃肠道排出。尽管初步数据显示使用该装置是安全的，且无严重并发症，但我们首次报告了成功处理与Elipse™ IGB相关的不良事件。
一名41岁女性在出现腹痛、呕吐和便秘两天后就诊于我们的急诊科。她的病史包括四次剖宫产，且在此次就诊前16周植入了Elipse™ IGB。患者就诊时生命体征稳定，腹部检查发现腹部轻度膨隆。腹部平片显示小肠梗阻（SBO），双重对比计算机断层扫描显示小肠扩张，在空肠远端的过渡区近端有少量游离液体。在梗阻部位近端进行了腹腔镜肠切开术，切开并排空球囊后看到并取出了球囊。肠切开切口用体内连续可吸收缝线缝合。患者恢复顺利，术后第4天出院。
我们讨论了植入Elipse™ IGB后发生SBO的可能病因，并对这类病例的手术和非手术治疗选择进行了简要文献综述。
尽管初步数据显示Elipse™ IGB是安全的，但仍可能发生并发症并得到成功处理。
