Intraluminal penetration of the hand in patients with adjustable silicone gastric banding: radiological findings

The aim of this study was to analyse radiological findings in patients surg ically treated for adjustable silicone gastric banding (ASGB) for morbid ob esity complicated by band penetration into the gastric lumen. We reviewed t he records of four patients with surgically confirmed penetration of gastri c band into the gastric lumen; three had preoperative opaque meal, one only a plain abdominal film. Vomiting was the presenting symptom in two cases, whereas others had new weight gain and loss of early satiety. Two patients had normally closed bands: radiography showed that their position had chang ed from previous controls and the barium meal had passed out of their lumen . Two patients had an open band. One patient had the band at the duodeno-je junal junction, and the tube connecting the band to the subcutaneous port p resented a winding course suggesting the duodenum, In the other case, both plain film and barium studies failed to demonstrate with certainty the intr agastric position of the band. As ASGB is becoming widely used, radiologist s need to be familiar with its appearances and its complications. Band pene tration into the stomach is a serious complication which needs band removal . Patients with this problem, often with non-specific symptoms and even tho se who are asymptomatic, are encountered during radiographic examinations r equested either for gastric problems or follow-up purposes, and have to be properly diagnosed.