Lap-band causing left gastric artery erosion presenting with torrential hemorrhage.
A 61-year-old lady presented 2 years after lap-band surgery with hemetemesis. She was stable on admission and band erosion was diagnosed on gastroscopy. Laparotomy was performed to remove the lap band. Upon division of the lap band, torrential hemorrhage from the eroded left gastric artery was encountered. An anterior gastrostomy was done to expose the artery. Intraoperative gastroscopy was also performed to define the cardioesophageal junction. The artery was ligated and the perforation and gastrostomy were repaired. The patient was discharged after 9 days in hospital. This case highlighted the potential injury to the left gastric artery in patients with band erosion presenting with hemetemesis. Torrential bleeding may be encountered upon division of the lap band, and this should be anticipated during laparotomy.
Png
Keng Siang
KS
Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore. kspng@pacific.net.sg
Rao
Jaideepraj
J
Lim
Khong Hee
KH
Chia
Kok Hoong
KH
D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation*; D006396:Hematemesis / Q000209:etiology*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D013270:Stomach / Q000098:blood supply* / Q000293:injuries*