Azar Loai, Tey Kai
Internal Medicine, Banner - University Medical Center Tucson, Tucson, USA.
Gastroenterology and Hepatology, University of Arizona College of Medicine - Tucson, Tucson, USA.
Cureus. 2025 Apr 6;17(4):e81808. doi: 10.7759/cureus.81808. eCollection 2025 Apr.
Intragastric balloons (IGBs) are widely used as a temporary weight-loss measure to induce early satiety and delay gastric emptying. Despite their safety profile, rare complications such as migration and small bowel obstruction (SBO) may occur, particularly when follow-up for timely removal is neglected. We present a case of a 48-year-old female with a history of obesity who arrived at the emergency department complaining of abdominal pain, nausea, vomiting, and obstipation of three days duration. Imaging revealed a dilated stomach and duodenum, with a fluid-filled IGB lodged in the proximal jejunum, causing SBO. Push enteroscopy was performed using a colonoscope, and the IGB was retrieved successfully from the jejunum into the stomach and removed entirely, avoiding the need for surgery. The patient recovered without complications and was discharged the following day. This case demonstrates an innovative approach to managing SBO caused by IGB migration. While surgery is typically the preferred method for small bowel impaction, endoscopic retrieval presents a viable, less invasive option. This article highlights the importance of gastroenterology consultation in managing migrated IGBs and reviews different techniques for endoscopic retrieval. We conclude that endoscopic management of migrated IGB causing SBO should be considered a first-line approach to minimize complications and shorten hospital stays, provided a backup surgical team is available.
胃内气球（IGB）被广泛用作一种临时减肥措施，以诱导早期饱腹感并延迟胃排空。尽管其安全性良好，但仍可能发生罕见的并发症，如移位和小肠梗阻（SBO），尤其是在忽视及时取出的随访时。我们报告一例48岁肥胖女性病例，她因腹痛、恶心、呕吐和便秘三天而到急诊科就诊。影像学检查显示胃和十二指肠扩张，一个充满液体的IGB卡在空肠近端，导致SBO。使用结肠镜进行推进式小肠镜检查，成功将IGB从空肠取出至胃内并完全移除，避免了手术的需要。患者康复且无并发症，于次日出院。该病例展示了一种处理由IGB移位引起的SBO的创新方法。虽然手术通常是小肠梗阻的首选方法，但内镜取出是一种可行的、侵入性较小的选择。本文强调了胃肠病学会诊在处理移位IGB中的重要性，并回顾了内镜取出的不同技术。我们得出结论，对于导致SBO的移位IGB，内镜处理应被视为一线方法，以尽量减少并发症并缩短住院时间，前提是有备用手术团队。
