Gastric band removal: mind the arterial anastomoses!

Orgera, Gianluigi; Ubaldi, Nicolò; Rossi, Tommaso; Rossi, Michele; Krokidis, Miltiadis (2024). Gastric band removal: mind the arterial anastomoses! Clinical journal of gastroenterology, 17(5), pp. 834-838. Springer 10.1007/s12328-024-02018-6

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Bariatric surgery may sometimes be challenging and may lead to severe complications. Surgical re-intervention in such cases is not the preferred option due to co-morbidities. When severe bleeding occurs, embolization of the lacerated vessels is the preferred minimal invasive management option and needs to be available if possible. We would like to report a case of young patient who underwent severe bleeding after migration of a gastric band. The patient was successfully embolized and the band was removed. However, on the second post-operative day, the patient complained again for acute abdominal pain and turned haemodynamically unstable. Fresh blood was aspirated from the surgical drain. A new emergency CT scan was performed and a new large pseudoaneurysm was revealed taking origin from the left gastric artery. The second bleeding occurred due to an anastomotic communication and was also successfully embolized. The main take home messages are that bariatric surgery may lead to several complications including bleeding, gastric band may cause vessel erosion but also offer a tamponade effect, endovascular embolization of the lacerated vessels is the preferred management and pseudoaneurysms arising in hepato-splenic or gastroduodenal arteries should be treated with the sandwich embolization technique.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Krokidis, Miltiadis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1865-7265

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

17 Jul 2024 13:50

Last Modified:

28 Sep 2024 00:14

Publisher DOI:

10.1007/s12328-024-02018-6

PubMed ID:

39008231

Uncontrolled Keywords:

Accessory left hepatic artery Bariatric Celiac axis variants Embolization Pseudoaneurysm

BORIS DOI:

10.48350/199025

URI:

https://boris.unibe.ch/id/eprint/199025

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