Intragastric balloon in the emergency department: an unusual cause of gastric outlet obstruction.
BACKGROUND
Obesity has become a worldwide epidemic and is associated with significant morbidity and mortality. Many strategies to promote weight loss, including medications and surgical techniques, have been developed; however, few have proven effective. As the rates of obesity and associated complications continue to climb, there is growing pressure on the medical community to develop less invasive procedures that can provide lasting weight loss results.


OBJECTIVE
One surgical treatment for obesity, available in several countries but not yet approved for use in the United States, is the intragastric balloon (IGB). The IGB is a temporary, space-occupying device placed endoscopically into the stomach to decrease gastric volume and provide a sense of early satiety. Our objective is to highlight potential complications of this device that emergency physicians should be familiar with, in particular, gastric outlet obstruction.


METHODS
We report the case of a morbidly obese 63-year-old Middle Eastern man who presented to an emergency department in Texas with mechanical gastric outlet obstruction 2 months after IGB placement. After three endoscopic attempts, the balloon was successfully removed and the obstruction relieved.


CONCLUSIONS
With an increasingly mobile and obese global population, emergency physicians should be aware of weight loss procedures such as the IGB and appropriate time-sensitive management of high-risk complications.
Department of Internal Medicine, Baylor College of Medicine, Houston, Texas.
Natalia I
NI
Khalaf
Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas.
Anish
A
Rawat
Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas.
Greg
G
Buehler
D020878:Device Removal / Q000379:methods*; D004636:Emergency Service, Hospital; D016099:Endoscopy, Gastrointestinal; D015905:Gastric Balloon / Q000009:adverse effects*; D017219:Gastric Outlet Obstruction / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged
gastric bypass; intragastric balloon; mechanical gastric outlet obstruction; obesity; weight loss