How Long Can an Intragastric Balloon Remain in the Stomach Safely? A Rare Case Report on 5.5 Years of Asymptomatic Retention.

Abstract

Intragastric balloons (IGBs) are widely used as a minimally invasive weight loss intervention for patients with obesity. While the recommended implantation period for most IGBs is 6 to 12 months, exceeding this duration is associated with an increased risk of complications such as deflation, migration, obstruction, and gastric perforation. However, the long-term safety of retained IGBs remains inadequately studied. We report a rare case of an asymptomatic 5.5-year retention of a Spatz3 IGB in a 29-year-old male patient. Initially implanted for obesity management with a body mass index (BMI) of 38 kg/m², the patient experienced an initial 15 kg weight loss, followed by partial weight regain. Despite multiple attempts to schedule removal, the patient postponed the procedure due to personal reasons and was lost to follow-up. Upon returning 5.5 years later, he remained asymptomatic with a BMI of 37.3 kg/m². Endoscopic examination revealed an intact gastric mucosa and a fully inflated balloon without evidence of degradation or leakage. The balloon was successfully removed endoscopically under sedation, and the postoperative course was uneventful. This case highlights that, under certain conditions, IGBs may remain intact beyond their recommended duration without causing immediate complications. However, this should not be interpreted as evidence of safety, as prolonged retention poses significant risks. Regular patient education, adherence to follow-up schedules, and improved tracking systems are crucial to prevent unintended long-term IGB retention and its associated complications.