• Cristiano Giardiello, Stefano Cristiano, Maria Rosaria Cerbone, Ersilia Troiano, Giuseppe Iodice, and Gennaro Sarrantonio.
• Department of Surgery, Hospital of Casoria S. Maria della Pietà, Naples, Italy.
• Obes Surg. 2003 Aug 1;13(4):658-60.

BackgroundThe Bioenterics Intragastric Balloon (BIB) has been a safe and effective method used in treatment of moderate obesity. Gastric perforation is a rare complication, and its possible sequelae are dangerous.MethodsA 52-year-old women (BMI 37 kg/m(2)), with hiatal hernia, moderate hypertension and dyspnea, 1 year ago underwent laparoscopic fundoplication. She now underwent positioning of a BIB filled with 500 cc of saline. After 8 days, 6 kg weight loss occurred and her clinical condition was satisfactory. On day 11, severe abdominal pain and vomiting occurred, which spontaneously regressed in the following 6-8 hours. Ultrasound confirmed the correct position of the BIB, and showed widespread abdominal meteorism. On day 18, acute abdomen with paralytic ileus occurred. On admission, CT scan documented hydropneumoperitonitis. At operation, a large perforation of the lesser curvature was found, with undigested food in the abdomen. She underwent peritoneal lavage, removal of the BIB, and suture of the gastric laceration.ResultsShe was discharged in good condition after 11 days.ConclusionAccording to our experience, fundoplication represents an absolute contraindication to positioning of a BIB.

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