Bamakhrama Khaled, Riyaz Suhana, Musthafa Mizna
Department of Gastroenterology, Rashid Hospital, Dubai, United Arab Emirates.
Dubai Medical College for Girls, Dubai, United Arab Emirates.
Eur J Case Rep Intern Med. 2024 Aug 19;11(9):004743. doi: 10.12890/2024_004743. eCollection 2024.
The intragastric balloon is a medical device inserted into the stomach endoscopically and filled with either air or more commonly, saline. Widely utilised since the 1980s, numerous studies have affirmed its safety and effectiveness as a temporary treatment for weight loss. Despite this, there have been reports of rare but severe complications associated with its usage.
We report the case of a 33-year-old female presented with two-day history of epigastric pain, nausea and vomiting. This occurred after having a gastric balloon placed endoscopically two months earlier. A contrast-enhanced abdominal CT scan revealed a partially deflated and migrated intragastric balloon in the proximal jejunum, causing intestinal obstruction without any signs of bowel perforation. The diagnosis was established as intestinal obstruction due to the migrated intragastric balloon. An emergency endoscopic procedure was undertaken, successfully removing the balloon thus highlighting a unique attempt to endoscopically retrieve a migrated intragastric balloon from the jejunum.
The efficacy of an intragastric balloon in reducing weight in a short time is gaining more popularity. The more common it becomes the more we must be vigilant about its complications. We advise regular follow-up of patients and emphasise patient education of possible signs and symptoms of intragastric balloon migration, which will avoid serious complications.
Endoscopic removal from the jejunum: Learn the procedure for endoscopic removal of a migrated gastric balloon from the jejunum, recognising it is possible without signs of perforation or leakage. Additionally, understand the importance of performing this procedure with surgical backup in a theatre to address any potential complications, such as perforation, during or after the procedure.The role of CT scans: Understand the crucial role of CT scans in diagnosing migrated gastric balloons or perforations related to gastric balloon procedures.Recognising and responding to balloon deflation: Identify signs of a deflated gastric balloon, such as methylene blue in the urine, and understand associated symptoms such as reduction in stomach fullness.
胃内球囊是一种通过内镜插入胃内并填充空气或更常见的生理盐水的医疗器械。自20世纪80年代广泛应用以来，众多研究证实了其作为减肥临时治疗方法的安全性和有效性。尽管如此，仍有关于其使用相关罕见但严重并发症的报道。
我们报告一例33岁女性病例，该患者有两天的上腹部疼痛、恶心和呕吐病史。这发生在两个月前经内镜放置胃内球囊之后。腹部增强CT扫描显示一个部分瘪陷并移位至空肠近端的胃内球囊，导致肠梗阻，且无任何肠穿孔迹象。诊断为胃内球囊移位导致的肠梗阻。进行了急诊内镜手术，成功取出球囊，从而突出了从空肠内镜取出移位胃内球囊的独特尝试。
胃内球囊在短期内减轻体重的功效越来越受欢迎。其使用越普遍，我们就越必须警惕其并发症。我们建议对患者进行定期随访，并强调对患者进行胃内球囊移位可能出现的体征和症状的教育，这将避免严重并发症。
从空肠进行内镜取出：学习从空肠内镜取出移位胃内球囊的操作程序，认识到在无穿孔或渗漏迹象的情况下是可行的。此外，了解在手术室进行此操作时配备手术后备力量以应对手术期间或之后任何潜在并发症（如穿孔）的重要性。CT扫描的作用：理解CT扫描在诊断移位胃内球囊或与胃内球囊手术相关的穿孔方面的关键作用。识别和应对球囊瘪陷：识别胃内球囊瘪陷的迹象，如尿液中的亚甲蓝，并了解相关症状，如胃部饱胀感减轻。
