Handaya Adeodatus Yuda, Subroto Polycarpus David, Aditya Azriel Farrel Kresna
Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
Int J Surg Case Rep. 2024 Aug;121:109997. doi: 10.1016/j.ijscr.2024.109997. Epub 2024 Jul 3.
Obesity is a major global health issue with serious consequences, including death. The intragastric balloon (IGB) is a bariatric surgery option but is limited to 6-12 months due to risks such as deflation, migration, and, rarely, intestinal obstruction. These complications are difficult to diagnose and manage.
A 46-year-old woman with an intragastric balloon for ten months experienced gastric distension, excessive salivation, and nausea, leading to hospitalization. Abdominal radiography and a CT scan revealed a small bowel obstruction caused by the balloon, located 40 cm before the ileocecal junction. A laparotomy was performed to explore the surgical site further. An ileotomy was conducted to remove the balloon during the surgery. The patient was discharged in stable condition after five days.
Complete small bowel obstruction due to intragastric balloon migration in bariatric surgery is very rare. Initial symptoms include mid-gut dilation, nausea, and vomiting. A CT scan is the best method to locate and identify the cause of intragastric balloon migration. Laparoscopy can be challenging in acute obstruction cases due to limited space, increasing the risk of iatrogenic bowel injury. Therefore, laparotomy with a semi-circular ileotomy is a safe treatment option.
Ileal obstruction due to intragastric balloon migration is a rare but serious complication of bariatric surgery, which requiring immediate surgical intervention. The use of a semi-circular ileotomy during laparotomy has proven to be an effective and safe treatment option for complete obstruction.
肥胖是一个重大的全球健康问题，会导致包括死亡在内的严重后果。胃内球囊（IGB）是一种减肥手术选择，但由于诸如球囊瘪缩、移位以及极少出现的肠梗阻等风险，其使用期限限制在6至12个月。这些并发症难以诊断和处理。
一名46岁女性，胃内放置球囊已十个月，出现胃胀、唾液过多和恶心症状，遂住院治疗。腹部X线造影和CT扫描显示，球囊导致小肠梗阻，梗阻部位在回盲瓣前方40厘米处。进行剖腹探查手术以进一步检查手术部位。术中通过回肠切开术取出球囊。患者术后五天病情稳定出院。
减肥手术中因胃内球囊移位导致完全性小肠梗阻极为罕见。初始症状包括中肠扩张、恶心和呕吐。CT扫描是定位和确定胃内球囊移位原因的最佳方法。在急性梗阻病例中，由于空间有限，腹腔镜检查可能具有挑战性，会增加医源性肠损伤风险。因此，采用半圆形回肠切开术的剖腹手术是一种安全的治疗选择。
胃内球囊移位导致的回肠梗阻是减肥手术中一种罕见但严重的并发症，需要立即进行手术干预。剖腹手术中采用半圆形回肠切开术已被证明是治疗完全性梗阻的一种有效且安全的选择。
