Laparoscopic Adjustable Gastric Band Erosion: A Rare Cause of Epigastric Pain

Abstract

This is a 50 year old female PMH including GERD and laparoscopic gastric banding in 2010 for morbid obesity who presented with several days of severe epigastric pain described as aching and pulling with associated nausea and vomiting. Two weeks prior to admission, patient had laparoscopic cholecystectomy for chronic cholelithiasis without any complications. She presented to the ED, where a CT scan of the abdomen and pelvis revealed gastric band erosion. Subsequent EGD confirmed presence of gastric band erosion, and patient underwent diagnostic laparoscopy and removal of gastric band. Intraoperative findings included severe adhesions of the band to the proximal stomach requiring adhesiolysis. Surgery was without complications, and patient was discharged home on post operative day 3. Gastric band erosion is an uncommon complication of laparoscopic adjustable gastric banding (LAGB), with an incidence of less than 1%.The preferred treatment in cases of band erosion is complete removal of gastric band laparoscopically. Our patient presented with epigastric pain from erosion 5 years post operatively. While rare, gastric band erosion should be a considered diagnosis in patients with history of LAGB and nonspecific epigastric pain.Figure 1Figure 2