P4193 - Acute Gastric Obstruction: A Case of Intragastric Balloon Obstruction and Successful Endoscopic Management

Vikash Kumar, MD¹, Hamsika Moparty, MD¹, Naresh kumar, MD¹, Dhir Gala, BS², Saigopal R. Gujjula, ³, Vijay Gayam, MD¹, Praneeth Bandaru, MD¹, Arnold Forlemu, MD, MPH¹, Vishnu Poojitha Ronda, MBBS, MD⁴, Derrick Cheung, MD^5
1Brooklyn Hospital Center, Brooklyn, NY; ²American University of the Caribbean School of Medicine, Plainview, NY; ³American University of Antigua, Coolidge, Saint John, Antigua and Barbuda; ⁴Mahatma Gandhi Medical College and Research Institute, Pondicherry, India, Brooklyn, NY; ⁵One Brooklyn Health, Brooklyn, NY

Introduction: Intragastric balloon placement is a popular non-surgical weight loss treatment that involves introducing a balloon into the stomach to decrease its volume and enhance satiety. Despite its effectiveness, balloon migration and displacement have emerged as potential complications associated with this procedure, leading to severe adverse events including gastric obstruction and perforation. Here, we present a case study involving a 42-year-old woman who underwent endoscopic removal of an Intragastric balloon due to suspected migration into the gastric antrum, resulting in occlusion and recurrent vomiting.

Case Description/Methods: A 42-year-old woman presented to the emergency department with complaints of worsening epigastric tenderness associated with nausea, non-bloody vomiting and watery diarrhea for six months after an Intragastric balloon placement in the Dominican Republic. On physical examination, the patient was found to be mildly dehydrated, with tenderness on palpation over the epigastrium and left upper quadrant of the abdomen. CT abdomen with contrast was significant for an Intragastric Balloon device in the stomach with narrowing of the gastric outlet (Figure 1A). The patient was admitted with an initial plan for conservative management. However, due to the persistence of her symptoms and imaging findings of balloon displacement, the decision was made to proceed with an emergency esophagogastroduodenoscopy (EGD) for balloon removal. EGD showed an inflated 10 cm intragastric balloon was found in the fundus and body of the stomach with fluid accumulation due to obstruction. Balloon was deflated and removed using a raptor grasping forceps and injection needle (Figure B, C, D). Following the procedure, the patient's symptoms improved rapidly, and she was discharged home with close follow-up.

Discussion: In recent years, Intragastric balloon placement has emerged as a promising non-surgical weight loss solution for individuals struggling with obesity. However, the occurrence of intragastric balloon migration and displacement remains a significant concern. Balloon migration can give rise to various complications, necessitating prompt recognition and appropriate management. Therefore, it is crucial to identify balloon migration or displacement in patients who initially present with gastrointestinal symptoms such as nausea, vomiting, and abdominal distention. Early recognition and treatment of balloon migration are essential as they have the potential to prevent life-threatening complications.



Disclosures:


Vikash Kumar, MD¹, Hamsika Moparty, MD¹, Naresh kumar, MD¹, Dhir Gala, BS², Saigopal R. Gujjula, ³, Vijay Gayam, MD¹, Praneeth Bandaru, MD¹, Arnold Forlemu, MD, MPH¹, Vishnu Poojitha Ronda, MBBS, MD⁴, Derrick Cheung, MD⁵. P4193 - Acute Gastric Obstruction: A Case of Intragastric Balloon Obstruction and Successful Endoscopic Management, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.