Gastric Ulcer Hemorrhage - a Potential Life-Threatening Complication of Intragastric Balloon Treatment of Obesity

Abstract

Background: Some morbidly obese patients do not qualify for bariatric surgery due to general health contraindications. Intragastric balloon treatment might be a therapeutic option in the above-mentioned cases. It can prime super-obese patients with end-stage disease for bariatric surgery. As a neoadjuvant therapy before surgery, it leads to a downstage of the disease by preliminary weight reduction, to an improvement in general health and, in summary, to a reduction of the perioperative risk. It is generally considered to be a safe method. However, due to the wide range of possible complications and unusual symptoms after intragastric balloon treatment, an interdisciplinary, instead of only a surgical or endoscopic, treatment and follow-up might be recommended in these patients. Case Report: We here describe a potential life-threatening complication in the form of gastric bleeding as a consequence of intragastric balloon treatment and simultaneous aspirin taking and Helicobacter pylori infection. Conclusion: There have been reports of some complications of intragastric balloon treatment. However, to the best of our knowledge there were no reports concerning life-threatening hemorrhage from gastric ulcer.

Intragastric balloon therapy leads to normalization of brain magnetic resonance spectroscopic markers of diabetes in morbidly obese patients

“…One OD had a gastric ulcer hemorrhage caused by taking aspirin against medical advice. This led to premature IGB removal one month prior to the scheduled time . However, his metabolite ratios were within the range of other patients taking part in the study.…”

Hidden dangers and updated labels on gastric balloons

“…IGB‐related AEs commonly include abdominal pain or discomfort usually epigastric, nausea, vomiting, halitosis, belching, flatulence, and psychological discomfort toward the presence of a foreign body 14. In one study, the most common side effects reported were nausea, abdominal pain, gastric erosion, and flatulence occurring 72%, 39%, 32%, and 24% of the time, respectively 15. Early retrieval of the IGB under conscious sedation or general anesthesia has resulted in aspiration pneumonia, perforation or mucosal tears within the esophagus, ulcers within the gastroesophageal junction, and pneumonitis 7,16,17.…”

“…14 In one study, the most common side effects reported were nausea, abdominal pain, gastric erosion, and flatulence occurring 72%, 39%, 32%, and 24% of the time, respectively. 15 Early retrieval of the IGB under conscious sedation or general anesthesia has resulted in aspiration pneumonia, perforation or mucosal tears within the esophagus, ulcers within the gastroesophageal junction, and pneumonitis. 7,16,17 Pancreatitis is an increasingly recognized complication of IGB insertion and generally occurs within 1-year post-IGB insertion.…”

Changes in resting metabolic rate and body composition due to intragastric balloon therapy

“…Among OB, 1 patient had a gastric ulcer hemorrhage caused by taking aspirin against medical advice. This led to premature IGB removal 1 month before the scheduled time [19]. However, his RMR and RMR/mass were within the range of results of other patients taking part in the study, and he was not excluded from the study.…”