Gastric Burst Due to Occlusion Ccaused by an Intragastric Balloon

A 53-year-old woman came to the emergency room reporting diffuse abdominal pain and vomiting in the previous 16 h. She reported insertion of an Orbera® intragastric balloon (IGB) 4 months earlier, with no incidents. Computed axial tomography revealed a rupture in the gastric fundus, with pneumoperitoneum and abundant food content observed in the abdominal cavity (Fig. 1).

Figure 1

The surgical approach involved an atypical laparotomy resection of the fundus with a linear stapler (Echelon-Flex™, loaded with 60 mm gold staples) reinforced with silk suture, abdominal lavage and Blake drains. The patient was discharged one week later (Fig. 2).

Figure 2

The use of IGB as an intermediate or definitive treatment in a weight loss protocol is considered a safe procedure. The most common complications are vomiting, abdominal pain and intestinal occlusion due to balloon rupture. Gastric rupture is a rare entity that should be considered.