The intragastric balloon (IGB) has been used as a temporary measure for weight reduction in the morbidly obese. The Elipse™ IGB is a capsule that is swallowed before being filled with 550mL of fluid and resides in the stomach for four months before being excreted from the gastrointestinal tract. Serious complications related to the device remain rare.
We present an unusual case of a 41-year-old woman presenting to our hospital following two days of abdominal pain and vomiting. She had an Elipse™ IGB inserted three months prior in Saudi Arabia. On examination her abdomen was distended and mildly tender on the right side. Computed tomography showed dilated small bowel with a transition zone in the mid jejunum associated with a foreign body.
Laparoscopy was performed and the transition point found in the mid-jejunum. An enterotomy was made at the transition point where the balloon was visualised intra-luminally and then extracted whole. The enterotomy was closed with intracorporeal continuous absorbable sutures. The IGB was removed from the abdominal cavity in an EndoCatch device. Upper GI endoscopy was also performed to exclude any remnant of the IGB remaining in the stomach. The patient developed paralytic ileus post-operatively which was managed conservatively and was discharged day 6 post op.
Although initial data has shown the Elipse™ IGB to be a relatively safe and efficacious temporary measure for weight reduction, rarely complications can occur. General surgeons should be alert to this and early imaging and laparoscopy are essential for management.