Gastric banding adjustment catheter dislodgement and perforation into the colon: case report.

Background: Laparoscopic adjustable gastric banding is a safe and effective method in bariatric surgery. Complications, which are relatively rare (10-20%), are related either to the band such as band slippage, pouch dilation, band erosion, intraluminal band migration or to the port-adjustment-tube system such as infection, tube disconnection and dislocation. Dislocation of the adjustment catheter perforating into the colon is extremely rare, our present case is the third publication on this complication.

Case description: In our present case, we report on an asymptomatic patient with intraluminal penetration of the dislodged adjustment tube into the colon 26 years after implantation of a gastric banding system. We revealed the complication randomly by positron emission tomography-computed tomography (PET-CT) in the course of a tumor staging of a newly diagnosed lung cancer. The gastric band was removed laparoscopically, the adjustment tube however, had to be cut through due to extended adhesions and could only partially be removed. The rest of the catheter passed spontaneously via rectum on the following day.

Conclusions: Intraluminal penetration of the dislodged adjustment tube into the colon is extremely rare and may be asymptomatic such as in case of our patient. Other relevant complications after gastric band implantation may also remain undetected. During long-term follow up, occasionally performed imaging should be considered also in asymptomatic patients with implanted gastric banding system.