Acute pancreatitis after intragastric balloon insertion: case report

Abstract

The intragastric balloon (IGB) is a relatively recent non-surgical weight loss technique that is now widely used in the world to treat obesity. However, IGB causes a wide range of adverse effects that range from minor ones, such as nausea, stomach pain and gastroesophageal reflux, to serious ones, such as ulceration, perforation, intestinal blockage and compression of adjusting structures. A 22-year-old Saudi woman presented to the emergency department (ED) with a history of upper abdominal pain that started 1 day before admission. The patient’s surgical background was unremarkable, and no other obvious pancreatitis risk factors were present. The patient underwent a minimally invasive treatment after being diagnosed with obesity (class 1), in which an IGB was inserted one and a half months prior to her ED presentation. She consequently began to lose weight (around 3 kg). The hypothesis states that pancreatitis following IGB insertion can be caused either by stomach distention and pancreatic compression at the tail or body or by ampulla obstruction due to balloon catheter migration at the duodenum. Heavy meal consumption, which may cause an increase in pancreatic compression, is another potential cause of pancreatitis in such patients. We believe that the IGB-induced compression of the pancreas at its tail or body was the likely cause of pancreatitis in our case. This case was reported because it is the first one from our city as far as we know. A few cases from Saudi Arabia have also been reported, and reporting them will help to improve doctors’ awareness of this complication, which can cause pancreatitis symptoms to be mistaken for something else because of the balloon-related effects on gastric distention.

Acute Necrotizing Pancreatitis Following Intragastric Balloon Insertion

“…While many of these cases were managed conservatively without the removal of the balloon, some of them required the removal of the balloon with or without other management strategies, along with standard inpatient management of acute pancreatitis. The prognosis has been generally excellent in all reported cases [9][10][11][12][13][14][15][16][17].…”

Endoluminal bariatric and metabolic therapies: state-of-the-art

“…The pooled AEs rate after Orbera from 68 studies showed that pain and nausea were frequent occurrences (33.7%), and early removal occurred in 7% of cases [22]. A concern that has been raised with fluidfilled balloons is their spontaneous hyperinflation and acute pancreatitis [23,24]. Albeit rare, early recognition and management are warranted.…”