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胃内球囊移位后小肠梗阻:一例报告

Small Bowel Obstruction Following Dislodgement of an Intragastric Balloon: A Case Report.

作者信息

Brizuela Laura, Samarah Hani, Cardona Nicole

机构信息

Internal Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.

Medicine, Herbert Wertheim College of Medicine, Miami, USA.

出版信息

Cureus. 2024 Aug 25;16(8):e67738. doi: 10.7759/cureus.67738. eCollection 2024 Aug.

Abstract

Obesity remains a significant health burden worldwide, requiring diverse and effective treatment strategies. The intragastric balloon (IGB), developed in the 1980s, offers a non-surgical option for weight management. Despite a decrease in usage, the IGB procedure continues to be an option for patients both domestically and abroad. In this article, we present the case involving a 30-year-old female who presented with severe abdominal complications 18 months after IGB placement in the Dominican Republic, well beyond the recommended six-month period for removal. This case highlights the critical risks associated with delayed IGB removal, including balloon rupture, migration, and symptoms indicative of gastric outlet obstruction. The literature supports increased complication rates with prolonged balloon retention, including risks such as gastric perforation, ulceration, and small bowel obstruction, emphasizing the importance of adhering to removal schedules. Furthermore, the case stresses the need for psychosocial evaluations before weight loss procedures and the necessity of alternative methods like laparoscopic removal when endoscopic extraction is unsuccessful. As obesity management evolves with new treatments like glucagon-like peptide-1 (GLP-1) analogs, ongoing research to understand their interaction with IGBs is crucial. This case underlines the importance of rigorous follow-up care, educating patients about procedural timelines, and conducting comprehensive evaluations to ensure the safety and effectiveness of IGB therapy.

摘要

肥胖仍然是全球一项重大的健康负担,需要多种有效的治疗策略。20世纪80年代研发的胃内气球(IGB)为体重管理提供了一种非手术选择。尽管其使用量有所下降,但IGB手术仍是国内外患者的一种选择。在本文中,我们介绍了一例病例,一名30岁女性在多米尼加共和国放置IGB 18个月后出现严重腹部并发症,这远远超过了建议的取出期限六个月。该病例突出了与IGB延迟取出相关的重大风险,包括气球破裂、迁移以及提示胃出口梗阻的症状。文献表明,随着气球保留时间延长,并发症发生率会增加,包括胃穿孔、溃疡和小肠梗阻等风险,这强调了遵守取出时间表的重要性。此外,该病例强调了在减肥手术前进行心理社会评估的必要性,以及在内镜取出不成功时采用腹腔镜取出等替代方法的必要性。随着肥胖管理随着胰高血糖素样肽-1(GLP-1)类似物等新疗法的发展而不断演变,持续开展研究以了解它们与IGB的相互作用至关重要。该病例强调了严格的随访护理、对患者进行手术时间线教育以及进行全面评估以确保IGB治疗的安全性和有效性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e9/11421580/d8013402e982/cureus-0016-00000067738-i01.jpg

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