A rare complication of laparoscopic adjustable gastric band: acute large bowel obstruction

With many thousands patients carrying laparoscopic adjustable gastric band (LAGB), long-term complications can appear emergently to any surgeon. We present a 64 year-old male who underwent placement of a laparoscopic adjustable gastric band (LAGB) years prior presented to the emergency department with concerning signs of an acute abdomen. Upon imaging review a large bowel obstruction at the level of the sigmoid colon, with ischemic changes, was discovered, caused by the patient’s LAGB catheter. The patient was taken emergently for an exploratory laparotomy during which the LAGB catheter was removed, resulting in restored bowel perfusion. Bowel obstructions are infrequent complications of LAGB. However most commonly they are limited to the small bowel. LAGB catheters resulting in large bowel obstructions are an extremely rare finding. Our review of the literature indicates that this is the first reported cause of a sigmoid obstruction caused by a LAGB. This case brings into view potential complications LAGB that can confront not only bariatric surgeons, but general and acute care surgeons as well. This report illustrates LAGB danger to the colon, and suggests how to manage, perhaps leading to early, life-saving intervention