Intragastric Balloon Hyperinsufflation as a Cause of Acute Obstructive Abdomen

Abstract

Recently, the Food and Drug Administration approved the use of the Orbera balloon for obesity treatment. However, the Food and Drug Administration later issued a warning about the possibility of 2 complications not previously reported: acute pancreatitis and balloon hyperinsufflation. This case report is intended to alert all clinicians that, although rare, cases of hyperinsufflation should be considered in patients with an intragastric balloon (IGB) and acute abdomen. IGB removal will resolve the complaints, provided there is no irreversible ischemia of the stomach walls. Care should be taken with respect to an increased risk of pulmonary aspiration at the time of balloon removal, and endotracheal intubation is highly recommended.

Antibiotics to Prevent Relapse of Adjustable Gastric Balloon Hyperinflation: Feasible for Balloon Maintenance?

“…The most common adverse events associated with IGBs are nausea, vomiting, and mild abdominal pain (up to 33% of the cases), which may require early removal [10]. Other possible complications include gastric ulcers, spontaneous deflation, rupture, colonization by fungus, balloon migration with intestinal obstruction, esophageal laceration/perforation, and gastric perforation [3, 9].…”

“…Other possible complications include gastric ulcers, spontaneous deflation, rupture, colonization by fungus, balloon migration with intestinal obstruction, esophageal laceration/perforation, and gastric perforation [3, 9]. ­Recently, the Food and Drugs Administration issued a warning about the possibility of another complication with these balloons – hyperinflation of the balloon requiring its early removal [10]. Symptoms of IGB hyperinflation include severe abdominal pain, abdominal distension (with or without associated pain), dyspnea, and vomiting [10].…”

“…­Recently, the Food and Drugs Administration issued a warning about the possibility of another complication with these balloons – hyperinflation of the balloon requiring its early removal [10]. Symptoms of IGB hyperinflation include severe abdominal pain, abdominal distension (with or without associated pain), dyspnea, and vomiting [10].…”

Spontaneous hyperinflation of intragastric balloon: What caused it?

“…C. parapsilosis can grow in the presence of high saline concentrations and can produce gas by fermentation, resulting in IGB hyperinflation [3,4]. The nutritive environment and slow gastric emptying after IGB placement may have promoted the rapid colonization of Candida [5]. Early recognition and IGB removal may prevent serious complications.…”

A Consideração De Aspectos Socioculturais No Tratamento Da Obesidade: Reflexões Introdutórias

“…A perda de peso com a inserção do BIG é notável, no entanto pode ocorrer algumas complicações como a hiperinsuflação espontânea, devido à produção de gás no interior da câmara do dispositivo, aumentando-o em tamanho, o que acarreta no desenvolvimento de sintomas obstrutivos agudos, como gastralgia intensa, êmese e dificuldade respiratória (GALVÃO NETO, 2020). A presença de fungos na superfície dos balões podem ser a causa da hiperinsuflação (DE QUADROS et al, 2018), esse fenômeno é também observado em próteses mamárias (ROBINSON JR et al, 2005), inclusive por fungos (WRIGHT et al, 2006). Porém, a origem desses microrganismos ainda é incerta, acredita-se que a contaminação ocorra durante a inserção do dispositivo (GALVÃO NETO, 2020).…”