Alkhathami Abdulmajeed Ali, Ahmed Zuhair Babiker, Alkhushayl Abdullah M, Alsaffar Faiz, Alshahrani Abdullah M
College of Medicine, University of Bisha, Bisha, Saudi Arabia.
Bariatric & Metabolic Surgery Unit, Department of General Surgery, King Abdullah Hospital, Bisha, Saudi Arabia.
J Surg Case Rep. 2023 Mar 7;2023(3):rjad093. doi: 10.1093/jscr/rjad093. eCollection 2023 Mar.
The intragastric balloon (IGB) is a relatively recent non-surgical weight loss technique that is now widely used in the world to treat obesity. However, IGB causes a wide range of adverse effects that range from minor ones, such as nausea, stomach pain and gastroesophageal reflux, to serious ones, such as ulceration, perforation, intestinal blockage and compression of adjusting structures. A 22-year-old Saudi woman presented to the emergency department (ED) with a history of upper abdominal pain that started 1 day before admission. The patient's surgical background was unremarkable, and no other obvious pancreatitis risk factors were present. The patient underwent a minimally invasive treatment after being diagnosed with obesity (class 1), in which an IGB was inserted one and a half months prior to her ED presentation. She consequently began to lose weight (around 3 kg). The hypothesis states that pancreatitis following IGB insertion can be caused either by stomach distention and pancreatic compression at the tail or body or by ampulla obstruction due to balloon catheter migration at the duodenum. Heavy meal consumption, which may cause an increase in pancreatic compression, is another potential cause of pancreatitis in such patients. We believe that the IGB-induced compression of the pancreas at its tail or body was the likely cause of pancreatitis in our case. This case was reported because it is the first one from our city as far as we know. A few cases from Saudi Arabia have also been reported, and reporting them will help to improve doctors' awareness of this complication, which can cause pancreatitis symptoms to be mistaken for something else because of the balloon-related effects on gastric distention.
胃内气球(IGB)是一种相对较新的非手术减肥技术,目前在全球广泛用于治疗肥胖症。然而,IGB会引发一系列不良反应,从轻微的如恶心、胃痛和胃食管反流,到严重的如溃疡、穿孔、肠梗阻和调节结构受压。一名22岁的沙特女性因入院前1天开始的上腹部疼痛病史就诊于急诊科。患者的手术史无异常,也不存在其他明显的胰腺炎危险因素。该患者在被诊断为肥胖症(1级)后接受了微创治疗,在其就诊于急诊科前一个半月插入了IGB。此后她开始体重减轻(约3千克)。该假说认为,插入IGB后发生的胰腺炎可能是由于胃扩张以及胰腺尾部或体部受压,或者是由于十二指肠处球囊导管移位导致壶腹梗阻。大量进食可能会导致胰腺受压增加,是此类患者胰腺炎的另一个潜在原因。我们认为在我们这个病例中,IGB导致的胰腺尾部或体部受压很可能是胰腺炎的病因。据我们所知,本病例是我们城市的首例报告。沙特阿拉伯也报告过几例,报告这些病例将有助于提高医生对这种并发症的认识,由于与气球相关的胃扩张效应,这种并发症可能会使胰腺炎症状被误诊为其他病症。