Translumenal Endoscopic Drainage of Abdominal Abscess Due to Early Migration of Adjustable Gastric Band

• Published in: Obesity surgery 2010-02, Vol.20 (2), p.247-250
• Main Authors: Campos, Josemberg M., Evangelista, Luis Fernando, Neto, Manoel P. Galvão, Pagnossin, Gilberto, Fernandes, Alberto, Ferraz, Álvaro A. B., Ferraz, Edmundo M.
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Abscess - etiology; Abdominal Abscess - surgery; Adult; Case Report; Case studies; Drainage; Endoscopy - methods; Foreign-Body Migration - complications; Gastrointestinal surgery; Gastroplasty - adverse effects; Humans; Infections; Male; Medicine; Medicine & Public Health; Obesity; Obesity, Morbid - surgery; Surgery; Treatment Outcome
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-009-9957-9

We describe the case of early band migration that developed into intraabdominal infection treated by natural orifice translumenal endoscopic surgery. A 40-year-old man was seen 4 years after gastric band placement. He complained of epigastric pain and fever. Gastroscopy revealed minimal gastric fundus erosion and a bulging of the antrum wall. Abdominal CT scan showed perigastric abscess surrounding the band tube. Antibiotic therapy was initiated, and endoscopic transgastric abscess drainage was performed. The endoscope was guided into the abscess cavity, and the band tubing was brought into the gastric lumen to serve as a stent to drain the infection, which ceased 5 days later. During the follow-up, the mucosa covering the band was incised in two more sessions to hasten the erosion process. Endoscopic removal was done 7 months after the drainage.