Clin Endosc.  2018 Nov;51(6):584-586. 10.5946/ce.2018.038.

Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss

• Reed L
• Edriss H
• Nugent K

• KMID: 2430402
• DOI: http://doi.org/10.5946/ce.2018.038

Abstract

Obesity in the United States is a medical crisis with many people attempting to lose weight with caloric restriction. Some patients choose minimally invasive weight loss solutions, such as intragastric balloon systems. These balloon systems were approved by the Federal Drug Administration (FDA) in 2015-2016 and have been considered safe, with minimal side effects. We report a patient with a two-day history of melena, abdominal pain, hypotension, and syncope which developed five months after placement of an intragastric balloon. Esophagogastroduodenoscopy with balloon removal revealed a small 8-mm gastric ulcer in the incisura. This gastric ulcer probably developed secondary to mechanical compression of the stomach mucosa by the gastric balloon which contained 900 mL of saline. The FDA is now investigating five deaths since 2016 associated with these second-generation balloons. Clinicians should be aware of these complications when evaluating patients with gastrointestinal complications, such as bleeding.

Keyword

Gastric balloon; Stomach ulcer; Gastrointestinal hemorrhage; Obesity

MeSH Terms

Abdominal Pain
Caloric Restriction
Endoscopy, Digestive System
Gastric Balloon
Gastrointestinal Hemorrhage
Hemodynamics*
Hemorrhage*
Humans
Hypotension
Melena
Mucous Membrane
Obesity
Stomach
Stomach Ulcer*
Syncope
United States
Weight Loss*

Figure

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  Fig. 1. Abdominal computed tomography showed two connected saline-filled gastric balloons (red arrows) in the patient.

• 

  Fig. 2. Linear ulcer found near the incisura (Forrest class III).

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