Gastroenterology, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, UK
Gastroenterology, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, UK.
BMJ Case Rep. 2022 Nov 17;15(11):e252952. doi: 10.1136/bcr-2022-252952.
A patient with a surgical history including an historic laparoscopic adjustable gastric band (LAGB) procedure presented to the emergency department with a history of haematemesis, intractable vomiting and abdominal pain 3 days following an outpatient oesophagogastroduodenoscopy (OGD) for chronic anaemia. A day after presentation to the emergency department, following admission, the patient underwent a repeat OGD. In contrast to her previous procedure, this demonstrated abnormal fluid and food deposition within what was originally reported to be a large hiatus hernia with a tight lower oesophageal sphincter. On corroboration with CT imaging obtained, in retrospect the endoscopic findings were attributed to slippage of the patient's adjustable gastric band. The band was loosened via its subcutaneous access port, following consultation with the surgical service, resulting in complete resolution of the patients' symptoms and she was discharged. This case is an example of gastroscopy as a rare trigger for the common complication of slipped gastric band following LAGB.
一位有手术史的患者,包括历史上的腹腔镜可调胃束带(LAGB)手术,在门诊食管胃十二指肠镜检查(OGD)治疗慢性贫血后 3 天出现呕血、顽固性呕吐和腹痛,前往急诊科就诊。在急诊科就诊 1 天后,患者在入院后再次接受了 OGD。与她之前的手术不同,这次检查显示异常的液体和食物沉积在最初报告的大裂孔疝和紧的食管下括约肌内。结合获得的 CT 成像,回顾性地将内镜检查结果归因于患者可调胃束带的滑脱。在与外科服务咨询后,通过皮下接入端口松开了束带,患者的症状完全缓解,随后出院。本例是胃窥镜检查作为 LAGB 后胃束带滑脱这一常见并发症的罕见诱因的一个例子。