title: An unusual case of significant weight loss following malposition of a laparoscopic adjustable gastric band.
abstract: OBJECTIVE
  Malposition or misplacement of gastric bands is a rare but recognised early complication of gastric band surgery. Malposition of the band would not normally result in significant weight loss after surgery.
  
  
  METHODS
  To our knowledge, we report the first case in the English literature of a malpositioned gastric band encircling the pericardial fat pad only, who presented with delayed symptoms of dysphagia and gastro-oesophageal reflux resulting in significant weight loss (>60% of excess body weight) approximately 6 years after primary surgery. The patient underwent a water-soluble contrast study with antero-posterior views which was suggestive of a slipped band. However, on laparoscopy the band was found to be encircling the pericardial fat pad.
  
  
  CONCLUSIONS
  We suggest that all contrast swallow studies for patients presenting with symptoms of gastric band slippage should include lateral views to exclude gastric band malposition, irrespective of the time of onset of symptoms after primary surgery.
authors.affiliation: Bariatric Surgery Unit, Homerton University Hospital, London, UK.
authors.forename: Peter Lawrence Zaki
authors.initials: PL
authors.lastname: Labib
authors.forename: Sanjay
authors.initials: S
authors.lastname: Agrawal
mesh_terms: D000273:Adipose Tissue; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010496:Pericardium; D011183:Postoperative Complications; D015431:Weight Loss