Simultaneous gastric and colonic erosions from gastric band and its tubing in the setting of recurrent intra-abdominal infection

Abstract

Chronic abdominal pain is often a diagnostic dilemma. We present a 59-year-old female with chronic generalized colicky abdominal and altered bowel habits. She was investigated with colonoscopy and CT abdomen. Patient has a history of recurrent diverticulitis and insertion laparoscopic adjustable gastric band. The colonoscopy revealed a tubular foreign body and diverticular disease. The tubular structure was confirmed to be gastric band tubing on CT abdomen, also showing simultaneous gastric and colonic erosions. She denies any gastric band port related infection or previous issues with gastric band. This case suggest that the cause of the erosion is due to recurrent episodes diverticulitis. She underwent wedge resection of large bowel and laparoscopic removal of gastric band. She had uneventful post-operative recovery.

Simultaneous erosion of gastric band into stomach and transverse colon

“…Erosion into the colon is less commonly observed, and the simultaneous erosion of the gastric band apparatus into both the stomach and the transverse colon is extremely uncommon. To our knowledge, there are no original research studies that investigate the prevalence of gastric band erosion into both the stomach and the colon simultaneously, and the pathology has been described in only a few case reports [2][3][4][5][6][7].…”

“…There are two primary proposed etiologies for erosion at the site of the gastric band: (1) elevated pressure caused by overfilling of the band or excessive food boluses and (2) rejection reaction against the silicon of the gastric band with circumferential fibrosis [8]. It has further been previously proposed that repeated episodes of intra-abdominal infection may cause subacute infection of gastric band and tubing, which, in the setting of friable colonic tissue, may predispose to erosion [2]. Furthermore, it has been suggested that the most likely mechanism leading to gastric band connecting tubing erosion is through bacterial colonization of the tubing due to port infection [9].…”

Introductory Chapter: Bariatric Surgery - Not Alone on This Long Road

“…Initially, patients lost weight but soon adapted to eat less and ate higher calory content [16,17]. But, unfortunately, the band itself was also a source of many other problems like infections [18], migration [19], erosion [20] and even, on rare occasions to gastric perforation [21]. As a result, conversion to other bariatric surgical procedures has not been uncommon [22].…”

Retrieval of Gastric Band Eroding Into the Stomach: A Gastrointestinal Fistula Case Managed Through a Combined Laparoscopic and Colonoscopic Approach

“…A high clinical index of suspicion is necessary to diagnose BE, as most patients are asymptomatic [6]. Previous studies have reported several cases of gastric BE in the gastrointestinal (GI) tract [6][7][8][9][10][11]. Conversely, the formation of a GI fistula is an extremely rare complication that can occur simultaneously with gastric BE [12,13].…”