eP269 Rare Case of Bowel Obstruction Secondary to Gastric Band Migration

Introduction Bowel obstruction secondary to gastric banding is a rare yet potentially serious complication. Gastric banding, a common bariatric procedure, may lead to mechanical or functional bowel obstruction. Prompt diagnosis and timely intervention are critical to prevent morbidity and mortality. This case highlights the clinical presentation, diagnostic approach, and management of this rare complication. Case Report A 56 year-old female with a history of laparoscopic adjustable gastric banding presented with acute, progressive abdominal pain, nausea, and vomiting of two days' duration. Physical examination revealed abdominal tenderness and distension, with decreased bowel sounds. Initial blood work was unremarkable, but abdominal radiography suggested small bowel obstruction. Subsequent computed tomography (CT) confirmed the presence of bowel obstruction caused by adhesions related to gastric band migration. Emergent surgical intervention was undertaken. Intraoperatively, distended small bowel loops found proximal to the loop of bowel around the migrated gastric band. The adhesions were carefully lysed, and the gastric band was removed. Postoperative recovery was uncomplicated, and the patient was discharged on postoperative day five with no residual symptoms. Follow-up imaging revealed no evidence of recurrent obstruction or other complications. Conclusion Although rare, bowel obstruction due to gastric band migration or associated adhesions should be considered in patients with a history of gastric banding who present with symptoms of obstruction. Early diagnosis through imaging and prompt surgical management are essential for favorable outcomes. Clinicians should maintain a high index of suspicion to address this complication effectively.