Midgut volvulus following laparoscopic gastric banding--a rare and dangerous situation.
Intestinal malrotation is usually encountered in infants. Its main complication is midgut volvulus, a situation that presents itself with bilious vomiting. This symptom allows for early surgical treatment. A delay in diagnosis and treatment may lead to catastrophic sequelae, such as extensive bowel necrosis and death. This situation is rare but well known in adults. Laparoscopic gastric banding is a popular option for treating morbid obesity. One of the consequences of this procedure may be impaired vomiting when there is an obstruction below the band. In this paper, we present a case in which a patient suffered from midgut volvulus 4 years after a laparoscopic gastric banding. Owing to impaired vomiting, the diagnosis was delayed, therefore, severely endangering the patient. This case prompted us to suggest that malrotation should be actively sought after before or during any bariatric procedure.
Arbell
Dan
D
Department of Pediatric Surgery, Hadassah--Hebrew University, Jerusalem, Israel. arbell@hadassah.org.il
Koplewitz
Benjamin
B
Zamir
Gideon
G
Bala
Miklosh
M
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D045822:Intestinal Volvulus / Q000209:etiology*; D007421:Intestine, Small / Q000473:pathology*; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy; D009765:Obesity / Q000601:surgery; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed