Pancreatitis from intra-gastric balloon insertion: Case report and literature review

Neel Gore; Praveen Ravindran; Daniel Leonard Chan; Kamalakanta Das; Peter H Cosman

doi:10.1016/j.ijscr.2018.03.016

Pancreatitis from intra-gastric balloon insertion: Case report and literature review

Int J Surg Case Rep. 2018:45:79-82. doi: 10.1016/j.ijscr.2018.03.016. Epub 2018 Mar 16.

Authors

Neel Gore¹, Praveen Ravindran², Daniel Leonard Chan¹, Kamalakanta Das¹, Peter H Cosman³

Affiliations

¹ Department of Surgery, Liverpool Hospital, Liverpool, NSW, Australia.
² Department of Surgery, Liverpool Hospital, Liverpool, NSW, Australia; University of Western Sydney, School of Surgery, Australia. Electronic address: Praveen.Ravindran@health.nsw.gov.au.
³ Department of Surgery, Liverpool Hospital, Liverpool, NSW, Australia; University of Western Sydney, School of Surgery, Australia.

Abstract

Introduction: Intra-Gastric Balloon (IGB) is increasingly used as a non-operative management strategy in bariatric patients. However, as IGB use has become more prevalent, new potentially life-threatening adverse effects have emerged. We report a case of IGB-related acute pancreatitis from a tertiary referral hospital. A literature review of electronic databases was conducted to identify other cases PRESENTATION OF CASE: A 20-year-old female presented to the emergency department with acute onset of epigastric pain on day-1 post-insertion of an IGB (Orbera^®). The diagnosis of acute pancreatitis was made on the basis of the clinical picture, with radiological and serological confirmation. Complete resolution of symptoms promptly followed endoscopic removal of the balloon.

Discussion: We examine all prior reported cases of IGB associated pancreatitis in the literature, as well as the impact of the particular balloon subtypes. Mass effect of the device on the pancreas or dislodgement of the rigid catheter into the second part of the duodenum appear to be the underlying cause in all cases. While there were no deaths reported, major sequelae have been noted, including presence of mucosal ischemia and failure to retrieve the balloon endoscopically, necessitating laparotomy.

Conclusion: Although the incidence of IGB-induced pancreatitis is still rare, this complication which must be highlighted as a potentially serious adverse outcome.

Keywords: Intragastric balloon; Obesity surgery; Pancreatitis.