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Case Reports
. 2025 Jun 19:9:78.
doi: 10.21037/acr-24-240. eCollection 2025.

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

György Gyimesi  1   2 , Stefan Kormann  1 , Markus Müller  3 , Dominik Müller  3 , Michael Christian Sulz  1
Affiliations
Case Reports

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

György Gyimesi et al. AME Case Rep. .

Abstract

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.

Keywords: Morbid obesity; adjustment tube migration; case report; gastric banding; intracolonic penetration.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://acr.amegroups.com/article/view/10.21037/acr-24-240/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Dislodged adjustment catheter. The visualized sections of the tube are marked with white stars subphrenic, near the spleen and in the descending colon. Contrast enhanced abdominal computed tomography (CT), frontal plane.
Figure 2
Figure 2
Visualized section of the catheter marked with a white star, forming a loop near the spleen. Contrast enhanced abdominal computed tomography (CT), coronal plane.
Figure 3
Figure 3
Endoscopic view of the catheter perforation site in the left colonic flexure.
Figure 4
Figure 4
Endoscopic view of the penetrated catheter in the descending colon.
See this image and copyright information in PMC

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