A rare case of proximal closed loop obstruction between gastric band and obstructed ventral hernia.

IF 0.4 Q4 SURGERY
Journal of Surgical Case Reports Pub Date : 2025-05-21 eCollection Date: 2025-05-01 DOI:10.1093/jscr/rjaf326
Leonid Drober, Ahmad Assalia, Abd Elkarim Darawsha
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引用次数: 0

Abstract

A 68-year-old woman with severe obesity presented with abdominal pain, nausea, and dehydration. She had a history of laparoscopic adjustable gastric banding (LAGB). Examination revealed tachycardia, hypotension, a chronic ventral hernia with mild tenderness, no peritonitis, and slight abdominal distension. A computed tomography (CT) scan showed massive gastric and dilation and obstruction at the level of gastro-esophageal junction (Band), proximal small bowel loop dilation, distal bowel collapse, and a ventral hernia involving high-grade obstruction and ischemic bowel. Exploratory laparotomy revealed a "closed-loop" obstruction between the gastric band and hernia. Her stomach was dilated and obstructed at the gastroesophageal junction, and ischemia affected 70 cm of the intestine in the hernia sac. This case emphasizes that patients with LAGB may be unable to vomit, and therefore a closed-loop obstruction should not be overlooked even without vomiting. Early diagnosis and timely treatment led to a favorable outcome.

胃带近端闭合袢梗阻及梗阻性腹疝1例。
68岁女性,严重肥胖,表现为腹痛、恶心和脱水。她有腹腔镜可调节胃束带(LAGB)病史。检查显示心动过速,低血压,慢性腹疝伴轻度压痛,无腹膜炎和轻微腹胀。计算机断层扫描(CT)显示胃-食管交界处(Band)有大量胃扩张和梗阻,近端小肠袢扩张,远端肠萎陷,腹侧疝伴重度梗阻和缺血性肠。剖腹探查发现胃带和疝之间有一个“闭环”阻塞。她的胃扩张并在胃食管交界处阻塞,缺血影响了疝囊内70厘米的肠。本病例强调LAGB患者可能无法呕吐,因此即使没有呕吐也不应忽视闭环梗阻。早期诊断和及时治疗取得了良好的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
559
审稿时长
11 weeks
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