Complications of gastric banding presenting to the ED.
Although laparoscopic adjustable gastric banding has become a widely used surgical modality for the treatment of morbid obesity, the technique and its complications remain fairly unknown to the medical community in general. Late complications occur in 10% to 20% of patients and usually manifest as upper gastrointestinal symptoms such as total food intolerance. However, seemingly unrelated symptoms such as chest pain may be the primary complaint. A rare but important complication to recognize and treat is gastric necrosis due to herniation of the stomach through the band. From the lessons learned with 2 patients and review of the literature, the diagnostic pitfalls and means for achieving a prompt diagnosis are discussed and a management protocol intended for emergency department staff is provided.
Landen
Serge
S
Department of Surgery, Clinique St Elisabeth, Brussels, Belgium.
Majerus
Bernard
B
Delugeau
Veronique
V
D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009336:Necrosis; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology*; D012086:Reoperation; D013270:Stomach / Q000473:pathology*