ORCP-488; No. of Pages 4
ARTICLE IN PRESS
Obesity Research & Clinical Practice (2015) xxx, xxx—xxx
CASE REPORT
Acute pancreatitis caused by intragastric balloon: A case report Iyad Issa a,∗, Alaa Taha a, Cecilio Azar b a
Rafik Hariri University Hospital, Department of Gastroenterology & Hepatology, Beirut, Lebanon b Middle East Institute of Health, Department of Gastroenterology & Hepatology, Bsalim, Lebanon Received 1 June 2015 ; received in revised form 14 July 2015; accepted 7 August 2015
KEYWORDS Intragastric balloon; Obesity; Pancreatitis; Weight loss
Summary Obesity represents a global hazard that predisposes to many serious health problems. Various solutions have been proposed to overcome obesity ranging from dietary balance to bariatric surgery. Intragastric balloons are a widely used measure to decrease weight, although they are advocated as safe devices, some major complications have been reported. We report a case of acute pancreatitis after insertion of a gastric balloon for weight reduction. Abdominal pain associated with nausea and vomiting maybe due to acute pancreatitis caused by compression of the pancreas by the balloon. It is advisable that physicians recognise these complications early to avoid serious and severe end-results. © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Introduction Obesity is a global ailment that affects all age groups regardless of socioeconomic status [1]. Rates have shown a worrisome surge recently with more than 2.1 billion individuals affected [2]. Obesity is classified according to body mass index (BMI), where a person is considered to be overweight
∗
Corresponding author at: Specialty Clinics Center 4B, Hamra, Maamari Street, 2034-7304 Beirut, Lebanon. Tel.: +961 3260908. E-mail address: [email protected] (I. Issa).
when his BMI exceeds 25 kg/m2 , and reaches obesity when it exceeds 30 kg/m2 [2]. Obesity increases the likelihood of various diseases, particularly cardiovascular diseases, hypertension, stroke and even cancer [1]. Dieting and exercise are the main treatment of obesity [1]. Adjuvant drugs have been shown to reduce appetite, and decrease fat absorption, however they lack a well established efficacy, and carry significant side effects [3,4]. Surgical intervention is considered for patients who have a BMI of 40 kg/m2 or even lower if they have failed conservative treatment or have serious comorbid conditions [3,4]. Intragastric balloon (IB)
http://dx.doi.org/10.1016/j.orcp.2015.08.003 1871-403X/© 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
ORCP-488; No. of Pages 4
ARTICLE IN PRESS
2
I. Issa et al.
insertion is a non surgical, short term modality for weight loss, which have shown acceptable efficacy in weight reduction. However several side effects were reported ranging from the simple like nausea and vomiting to the more serious such as bowel perforation [5—8]. We present here a case of acute pancreatitis following insertion of a saline filled intragastric balloon.
Case report Our patient is a 26 year old female (BMI of 28) who presented to our obesity clinic for weight management. She had attempted several cycles of dietary restriction and exercise with suboptimal results. Her past medical history included hyperinsulinemia as documented by her blood profile. She reported no history of abdominal pain and her system review was essentially negative. An ultrasound of abdomen previously performed was unremarkable. After an informed consent was obtained, and risk and benefits were clearly explained, a Biogen Intragastric Balloon (BIB) was inserted and filled with 650 cc of methylene blue tinged normal saline. The procedure was smooth and straight forward and no immediate complications were noted. The patient was monitored for an hour post-procedure and discharged home on anti-emetics and anti-spasmodics as well as PPI. Two days later she presented to the emergency department, with epigastric pain, and intractable vomiting. She was given anti-emetics and pain killers and was discharged home after improvement of her symptoms. She presented again 24 h later with vomiting, but this time the pain was severe and radiating to the back. She was admitted to the hospital for IV hydration and further management. Her blood tests revealed significant elevation in lipase and amylase with normal transaminases and bilirubin (Table 1). After IV hydration, a CT scan of abdomen was performed, it revealed compression of the pancreas at the level of its body by the dilated stomach containing the balloon with subsequent main pancreatic duct dilatation (Fig. 1). Imaging did not reveal any bile duct dilatation or gall bladder stones and the blood profile showed a normal triglycerides level. And since the patient was not an alcohol consumer, the most likely cause was deemed traumatic compression by the balloon-filled stomach. The second day the BIB was smoothly removed; the pain subsided along with significant decrease of the pancreatic enzymes (amylase and lipase). She was discharged two days later in stable condition with no recurrence of symptoms.
Table 1 Laboratory values of the patient upon admission. Laboratory test
Value
WBC Neutrophils Hematocrit Platelets ESR INR Creatinine Sodium Potassium Chloride CO2 Calcium SGOT(AST) SGPT(ALT) Alkaline phosphatase GGT Total bilirubin Direct bilirubin Amylase Lipase Cholesterol Triglyceride HDL cholesterol LDL cholesterol CRP Total protein Albumin Globulin
9.1 × 103 /l 64% 37% 345 × 103 /l 32 mm 1.29 0.89 mg/dl 142 mmol/L 3.2 mmol/L 104 mmol/L 24 mmol/L 9.68 mg/dl 29 IU/L 45 IU/L 77 IU/L 44 IU/L 0.77 mg/dl 0.21 mg/dl 520 730 150 mg/dl 124 mg/dl 23 mg/dl 102 mg/dl 17 7.4 g/dl 4.2 g/dl 3.2 g/dl
Discussion Intragastric balloons are a non surgical, endoscopically performed procedure, used to reduce the size of the stomach and thus its capacity to accommodate food [9]. The first generation of intragastric balloons was introduced in 1985 as Garren-Edwards Gastric Bubble (GEGB) to be abandoned soon after
Fig. 1 CT scan showing the stomach filled by the intragastric balloon compressing the pancreas.
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
ORCP-488; No. of Pages 4
ARTICLE IN PRESS
Intragastric balloon in the stomach as a cause of acute pancreatitis due to significant side effects [6,9—12]. Later newer balloons were introduced, the most widely used is the Bioenterics intragastric balloon (BIB) which is filled with saline and showed acceptable results with weight reduction [6]. The Heliosphere which was introduced in 2004, is a double bagged polymer filled with air [6], despite being lighter than the water-filled one these types of balloons showed difficulty at the time of removal [13]. The most recent addition to the repertoire of balloons is the Spatz Adjustable Balloon System (ABS), introduced in 2010. The new innovation is that it can be placed for one year and benefits from multiple adjustments of volume through progressive upward regulation. This helps overcome the usual weight plateau that occurs 3 months into the placement due to the physiologic accommodation of the stomach [14]. All intragastric balloons are generally considered safe, with nausea and vomiting being the most frequent side effects, mainly during the first week [15,16]. Although BIB related severe adverse events are rare, few reports have linked them to instances of intestinal obstruction and perforation [6]. However, Spatz balloon have been labelled with higher rates of serious side effects [17], of which many lead to balloon removal [16], but no mortality related to the device was noted. Acute pancreatitis after BIB balloon has rarely been experienced, only three cases previously reported in the literature [18—20], two cases using BIB, and one with the newer Spatz Balloon. Acute pancreatitis may be induced either by direct compression of the pancreatic duct by the dilated stomach, as reported in our case, or due to the migration of the catheter causing obstruction. Both BIB-induced pancreatitis were mild, with complete recovery after balloon removal. This was clearly described by Mohammed et al. in an young female diagnosed with mild pancreatitis, rather late (10 weeks) after BIB insertion. The recovery course was fast and smooth [18]. Shelton et al. mentioned a 32 year old man who developed mild acute pancreatitis 10 weeks after the insertion of Orbera intragastric balloon, diagnosis was made after the patient complained of acute epigastric pain associated with nausea, and elevated lipase > 400 U/L. Symptoms and biochemical disturbances resolved after balloon removal by endoscopy [19]. The Spatz balloon induced pancreatitis followed a more serious course, as mentioned by Vongsuvanh et al. their 30 year old man, with severe necrotising pancreatitis and gastric wall ischaemia, 11 months after balloon insertion [20]. This required surgical intervention to remove the impacted catheter.
3
Conclusion Intragastric balloon therapy may be considered a valid option for patients unresponsive to conventional weight loss strategies. It remains a popular choice despite the disappointing long term results. Balloons are generally considered a safe weight reduction tool, despite few sporadic serious adverse effect reports. It is important however to keep these patients under close follow up and recognise the complications early to avoid a detrimental course and gloomy end-result.
Conflict of interest The authors report no conflict of interest.
Funding They received no funding for this manuscript.
References [1] Tsigosa C, Hainerb V, Basdevant A, Finer N, Fried M, MathusVliegen E, et al. Management of obesity in adults: European Clinical Practice Guidelines. Obes Facts 2008;1(2):106—16, http://dx.doi.org/10.1159/000126822. [2] Wise J. Obesity rates rise substantially worldwide. BMJ 2014;348(May), http://dx.doi.org/10.1136/bmj.g2180, g3582—g3582. [3] Snow V, Barry P, Fitterman N, Qaseem A, Weiss K. Pharmacologic and surgical management of obesity in primary care, a clinical practice guideline from the American College of Physicians. Ann Intern Med 2005;142(7):525, http://dx.doi.org/10.1016/j.accreview.2005.06.023. [4] Li Z, Maglione M, Tu W, Mohica W, Arterburn D, Shugarman LR, et al. Meta analysis: pharmacologic treatment of obesity. Ann Intern Med 2005;142(7):532, http://dx.doi.org/ 10.7326/0003-4819-142-7-200504050-00012. [5] Kotzampassi K, Grosomanidis V, Papakostas P, Penna S, Eleftheriadis C. 500 intragastric balloons: what happens 5 years thereafter? Obes Surg 2012;22(6):896—903, http://dx.doi.org/10.1007/s11695-012-0607-2. [6] Imaz I, Cervell CM, Elena E, Sandra-Gutierrez JM, Gonzalez-Enriquez J. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg 2008;18(7):841—6, http://dx.doi.org/10.1007/ s11695-007-9331-8. [7] Dumonceau JM. Evidence-based review of the Bioenterics intragastric balloon for weight loss. Obes Surg 2008;18(12):1611—7, http://dx.doi.org/10.1007/s11695008-9593-9. [8] Bozkurt S, Coskun H. The early results of intragastric balloon application of different BMI groups. Eur Surg 2012;44(6):383—7, http://dx.doi.org/10.1007/ s10353-012-0167-7. [9] Mathus-Vliegen EMH, Tytgat GNJ. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
ORCP-488; No. of Pages 4
ARTICLE IN PRESS
4
I. Issa et al.
[10]
[11]
[12]
[13]
[14]
[15]
efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc 2000;61(1):19—27, http://dx.doi.org/10.1016/s00165107(04)02406-x. Caglar E, Dobrucali A, Bal K. Gastric balloon to treat obesity: filled with air or fluid. Dig Endosc 2012;25(5):502—7, http://dx.doi.org/10.1111/den.12021. Genco A, Cipriano M, Bacci V, Cuzzolaro M, Materia A, Raparelli M, et al. BioEnterics Intragastric Balloon (BIBs), a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes 2005;30(1):129—33, http://dx.doi.org/10.1038/sj.ijo.0803094. Mathus-Vliegen EMH. Intragastric balloon treatment for obesity what does it really offer. Dig Dis 2008;26(1):40—4, http://dx.doi.org/10.1159/000109385. Trande P, Mussetto A, Mirante VG, De Martinis E, Olivetti G, Conigliaro RL, et al. Efficacy Tolerance and safety of new intragastric air-filled balloon (Heliosphere BAG) for obesity, the experience of 17 cases. Obes Surg 2008;20(9):1227—30, http://dx.doi.org/10.1007/s11695-008-9786-2. Brooks J, Srivastava ED, Mathus-Vliegen EMH. One-year adjustable intragastric balloons results in 73 consecutive patients in the UK. Obes Surg 2014;24(5):813—9, http://dx.doi.org/10.1007/s11695-014-1176-3. Giardiello C, Borrelli A, Silvestri E, Antognozzi V, Iodice G, Lorenzo M. Air-filled vs water-filled intragastric
[16]
[17]
[18]
[19]
[20]
balloon a prospective randomized study. Obes Surg 2012;22(12):1916—9, http://dx.doi.org/10.1007/s11695012-0786-x. Machytka E, Klvana P, Kornbluth A, Pelkin S, Mathus-Vliegen LE, Gostout C, et al. Adjustable intragastric balloons a 12month pilot trial in endoscopic weight loss management. Obes Surg 2011;21(10):1499—507, http://dx.doi.org/10. 1007/s11695-011-0424-z. Genco A, Dellepiane D, Baglio G, Cappelletti F, Frangella F, Masselli R, et al. Adjustable intragastric balloon vs non-adjustable intragastric balloon: case—control study on complications, tolerance, and efficacy. Obes Surg 2013;23(7):953—8, http://dx.doi.org/10.1007/ s11695-013-0891-5. Mohammed AE, Benmousa A. Acute pancreatitis complicating intragastric balloon insertion. Case Rep Gastroenterol 2008;2(3):291—5, http://dx.doi.org/10.1159/000151287. Shelton E, Froomes P, Fink MA. Gastrointestinal: balloon pancreatitis. J Gastroenterol Hepatol 2012;27(5), http://dx.doi.org/10.1111/j.1440-1746.2012.07102.x, 986—986. Vongsuvanh R, Pleass H, Van der Poorten D. Acute necrotizing pancreatitis, gastric ischemia, and portal venous gas complicating intragastric balloon placement. Endoscopy 2012;44(S 02):E383—4, http://dx.doi.org/10.1055/s-0032-1310146.
Available online at www.sciencedirect.com
ScienceDirect
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
ARTICLE IN PRESS
Obesity Research & Clinical Practice (2015) xxx, xxx—xxx
CASE REPORT
Acute pancreatitis caused by intragastric balloon: A case report Iyad Issa a,∗, Alaa Taha a, Cecilio Azar b a
Rafik Hariri University Hospital, Department of Gastroenterology & Hepatology, Beirut, Lebanon b Middle East Institute of Health, Department of Gastroenterology & Hepatology, Bsalim, Lebanon Received 1 June 2015 ; received in revised form 14 July 2015; accepted 7 August 2015
KEYWORDS Intragastric balloon; Obesity; Pancreatitis; Weight loss
Summary Obesity represents a global hazard that predisposes to many serious health problems. Various solutions have been proposed to overcome obesity ranging from dietary balance to bariatric surgery. Intragastric balloons are a widely used measure to decrease weight, although they are advocated as safe devices, some major complications have been reported. We report a case of acute pancreatitis after insertion of a gastric balloon for weight reduction. Abdominal pain associated with nausea and vomiting maybe due to acute pancreatitis caused by compression of the pancreas by the balloon. It is advisable that physicians recognise these complications early to avoid serious and severe end-results. © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Introduction Obesity is a global ailment that affects all age groups regardless of socioeconomic status [1]. Rates have shown a worrisome surge recently with more than 2.1 billion individuals affected [2]. Obesity is classified according to body mass index (BMI), where a person is considered to be overweight
∗
Corresponding author at: Specialty Clinics Center 4B, Hamra, Maamari Street, 2034-7304 Beirut, Lebanon. Tel.: +961 3260908. E-mail address: [email protected] (I. Issa).
when his BMI exceeds 25 kg/m2 , and reaches obesity when it exceeds 30 kg/m2 [2]. Obesity increases the likelihood of various diseases, particularly cardiovascular diseases, hypertension, stroke and even cancer [1]. Dieting and exercise are the main treatment of obesity [1]. Adjuvant drugs have been shown to reduce appetite, and decrease fat absorption, however they lack a well established efficacy, and carry significant side effects [3,4]. Surgical intervention is considered for patients who have a BMI of 40 kg/m2 or even lower if they have failed conservative treatment or have serious comorbid conditions [3,4]. Intragastric balloon (IB)
http://dx.doi.org/10.1016/j.orcp.2015.08.003 1871-403X/© 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
ORCP-488; No. of Pages 4
ARTICLE IN PRESS
2
I. Issa et al.
insertion is a non surgical, short term modality for weight loss, which have shown acceptable efficacy in weight reduction. However several side effects were reported ranging from the simple like nausea and vomiting to the more serious such as bowel perforation [5—8]. We present here a case of acute pancreatitis following insertion of a saline filled intragastric balloon.
Case report Our patient is a 26 year old female (BMI of 28) who presented to our obesity clinic for weight management. She had attempted several cycles of dietary restriction and exercise with suboptimal results. Her past medical history included hyperinsulinemia as documented by her blood profile. She reported no history of abdominal pain and her system review was essentially negative. An ultrasound of abdomen previously performed was unremarkable. After an informed consent was obtained, and risk and benefits were clearly explained, a Biogen Intragastric Balloon (BIB) was inserted and filled with 650 cc of methylene blue tinged normal saline. The procedure was smooth and straight forward and no immediate complications were noted. The patient was monitored for an hour post-procedure and discharged home on anti-emetics and anti-spasmodics as well as PPI. Two days later she presented to the emergency department, with epigastric pain, and intractable vomiting. She was given anti-emetics and pain killers and was discharged home after improvement of her symptoms. She presented again 24 h later with vomiting, but this time the pain was severe and radiating to the back. She was admitted to the hospital for IV hydration and further management. Her blood tests revealed significant elevation in lipase and amylase with normal transaminases and bilirubin (Table 1). After IV hydration, a CT scan of abdomen was performed, it revealed compression of the pancreas at the level of its body by the dilated stomach containing the balloon with subsequent main pancreatic duct dilatation (Fig. 1). Imaging did not reveal any bile duct dilatation or gall bladder stones and the blood profile showed a normal triglycerides level. And since the patient was not an alcohol consumer, the most likely cause was deemed traumatic compression by the balloon-filled stomach. The second day the BIB was smoothly removed; the pain subsided along with significant decrease of the pancreatic enzymes (amylase and lipase). She was discharged two days later in stable condition with no recurrence of symptoms.
Table 1 Laboratory values of the patient upon admission. Laboratory test
Value
WBC Neutrophils Hematocrit Platelets ESR INR Creatinine Sodium Potassium Chloride CO2 Calcium SGOT(AST) SGPT(ALT) Alkaline phosphatase GGT Total bilirubin Direct bilirubin Amylase Lipase Cholesterol Triglyceride HDL cholesterol LDL cholesterol CRP Total protein Albumin Globulin
9.1 × 103 /l 64% 37% 345 × 103 /l 32 mm 1.29 0.89 mg/dl 142 mmol/L 3.2 mmol/L 104 mmol/L 24 mmol/L 9.68 mg/dl 29 IU/L 45 IU/L 77 IU/L 44 IU/L 0.77 mg/dl 0.21 mg/dl 520 730 150 mg/dl 124 mg/dl 23 mg/dl 102 mg/dl 17 7.4 g/dl 4.2 g/dl 3.2 g/dl
Discussion Intragastric balloons are a non surgical, endoscopically performed procedure, used to reduce the size of the stomach and thus its capacity to accommodate food [9]. The first generation of intragastric balloons was introduced in 1985 as Garren-Edwards Gastric Bubble (GEGB) to be abandoned soon after
Fig. 1 CT scan showing the stomach filled by the intragastric balloon compressing the pancreas.
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
ORCP-488; No. of Pages 4
ARTICLE IN PRESS
Intragastric balloon in the stomach as a cause of acute pancreatitis due to significant side effects [6,9—12]. Later newer balloons were introduced, the most widely used is the Bioenterics intragastric balloon (BIB) which is filled with saline and showed acceptable results with weight reduction [6]. The Heliosphere which was introduced in 2004, is a double bagged polymer filled with air [6], despite being lighter than the water-filled one these types of balloons showed difficulty at the time of removal [13]. The most recent addition to the repertoire of balloons is the Spatz Adjustable Balloon System (ABS), introduced in 2010. The new innovation is that it can be placed for one year and benefits from multiple adjustments of volume through progressive upward regulation. This helps overcome the usual weight plateau that occurs 3 months into the placement due to the physiologic accommodation of the stomach [14]. All intragastric balloons are generally considered safe, with nausea and vomiting being the most frequent side effects, mainly during the first week [15,16]. Although BIB related severe adverse events are rare, few reports have linked them to instances of intestinal obstruction and perforation [6]. However, Spatz balloon have been labelled with higher rates of serious side effects [17], of which many lead to balloon removal [16], but no mortality related to the device was noted. Acute pancreatitis after BIB balloon has rarely been experienced, only three cases previously reported in the literature [18—20], two cases using BIB, and one with the newer Spatz Balloon. Acute pancreatitis may be induced either by direct compression of the pancreatic duct by the dilated stomach, as reported in our case, or due to the migration of the catheter causing obstruction. Both BIB-induced pancreatitis were mild, with complete recovery after balloon removal. This was clearly described by Mohammed et al. in an young female diagnosed with mild pancreatitis, rather late (10 weeks) after BIB insertion. The recovery course was fast and smooth [18]. Shelton et al. mentioned a 32 year old man who developed mild acute pancreatitis 10 weeks after the insertion of Orbera intragastric balloon, diagnosis was made after the patient complained of acute epigastric pain associated with nausea, and elevated lipase > 400 U/L. Symptoms and biochemical disturbances resolved after balloon removal by endoscopy [19]. The Spatz balloon induced pancreatitis followed a more serious course, as mentioned by Vongsuvanh et al. their 30 year old man, with severe necrotising pancreatitis and gastric wall ischaemia, 11 months after balloon insertion [20]. This required surgical intervention to remove the impacted catheter.
3
Conclusion Intragastric balloon therapy may be considered a valid option for patients unresponsive to conventional weight loss strategies. It remains a popular choice despite the disappointing long term results. Balloons are generally considered a safe weight reduction tool, despite few sporadic serious adverse effect reports. It is important however to keep these patients under close follow up and recognise the complications early to avoid a detrimental course and gloomy end-result.
Conflict of interest The authors report no conflict of interest.
Funding They received no funding for this manuscript.
References [1] Tsigosa C, Hainerb V, Basdevant A, Finer N, Fried M, MathusVliegen E, et al. Management of obesity in adults: European Clinical Practice Guidelines. Obes Facts 2008;1(2):106—16, http://dx.doi.org/10.1159/000126822. [2] Wise J. Obesity rates rise substantially worldwide. BMJ 2014;348(May), http://dx.doi.org/10.1136/bmj.g2180, g3582—g3582. [3] Snow V, Barry P, Fitterman N, Qaseem A, Weiss K. Pharmacologic and surgical management of obesity in primary care, a clinical practice guideline from the American College of Physicians. Ann Intern Med 2005;142(7):525, http://dx.doi.org/10.1016/j.accreview.2005.06.023. [4] Li Z, Maglione M, Tu W, Mohica W, Arterburn D, Shugarman LR, et al. Meta analysis: pharmacologic treatment of obesity. Ann Intern Med 2005;142(7):532, http://dx.doi.org/ 10.7326/0003-4819-142-7-200504050-00012. [5] Kotzampassi K, Grosomanidis V, Papakostas P, Penna S, Eleftheriadis C. 500 intragastric balloons: what happens 5 years thereafter? Obes Surg 2012;22(6):896—903, http://dx.doi.org/10.1007/s11695-012-0607-2. [6] Imaz I, Cervell CM, Elena E, Sandra-Gutierrez JM, Gonzalez-Enriquez J. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg 2008;18(7):841—6, http://dx.doi.org/10.1007/ s11695-007-9331-8. [7] Dumonceau JM. Evidence-based review of the Bioenterics intragastric balloon for weight loss. Obes Surg 2008;18(12):1611—7, http://dx.doi.org/10.1007/s11695008-9593-9. [8] Bozkurt S, Coskun H. The early results of intragastric balloon application of different BMI groups. Eur Surg 2012;44(6):383—7, http://dx.doi.org/10.1007/ s10353-012-0167-7. [9] Mathus-Vliegen EMH, Tytgat GNJ. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
ORCP-488; No. of Pages 4
ARTICLE IN PRESS
4
I. Issa et al.
[10]
[11]
[12]
[13]
[14]
[15]
efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc 2000;61(1):19—27, http://dx.doi.org/10.1016/s00165107(04)02406-x. Caglar E, Dobrucali A, Bal K. Gastric balloon to treat obesity: filled with air or fluid. Dig Endosc 2012;25(5):502—7, http://dx.doi.org/10.1111/den.12021. Genco A, Cipriano M, Bacci V, Cuzzolaro M, Materia A, Raparelli M, et al. BioEnterics Intragastric Balloon (BIBs), a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes 2005;30(1):129—33, http://dx.doi.org/10.1038/sj.ijo.0803094. Mathus-Vliegen EMH. Intragastric balloon treatment for obesity what does it really offer. Dig Dis 2008;26(1):40—4, http://dx.doi.org/10.1159/000109385. Trande P, Mussetto A, Mirante VG, De Martinis E, Olivetti G, Conigliaro RL, et al. Efficacy Tolerance and safety of new intragastric air-filled balloon (Heliosphere BAG) for obesity, the experience of 17 cases. Obes Surg 2008;20(9):1227—30, http://dx.doi.org/10.1007/s11695-008-9786-2. Brooks J, Srivastava ED, Mathus-Vliegen EMH. One-year adjustable intragastric balloons results in 73 consecutive patients in the UK. Obes Surg 2014;24(5):813—9, http://dx.doi.org/10.1007/s11695-014-1176-3. Giardiello C, Borrelli A, Silvestri E, Antognozzi V, Iodice G, Lorenzo M. Air-filled vs water-filled intragastric
[16]
[17]
[18]
[19]
[20]
balloon a prospective randomized study. Obes Surg 2012;22(12):1916—9, http://dx.doi.org/10.1007/s11695012-0786-x. Machytka E, Klvana P, Kornbluth A, Pelkin S, Mathus-Vliegen LE, Gostout C, et al. Adjustable intragastric balloons a 12month pilot trial in endoscopic weight loss management. Obes Surg 2011;21(10):1499—507, http://dx.doi.org/10. 1007/s11695-011-0424-z. Genco A, Dellepiane D, Baglio G, Cappelletti F, Frangella F, Masselli R, et al. Adjustable intragastric balloon vs non-adjustable intragastric balloon: case—control study on complications, tolerance, and efficacy. Obes Surg 2013;23(7):953—8, http://dx.doi.org/10.1007/ s11695-013-0891-5. Mohammed AE, Benmousa A. Acute pancreatitis complicating intragastric balloon insertion. Case Rep Gastroenterol 2008;2(3):291—5, http://dx.doi.org/10.1159/000151287. Shelton E, Froomes P, Fink MA. Gastrointestinal: balloon pancreatitis. J Gastroenterol Hepatol 2012;27(5), http://dx.doi.org/10.1111/j.1440-1746.2012.07102.x, 986—986. Vongsuvanh R, Pleass H, Van der Poorten D. Acute necrotizing pancreatitis, gastric ischemia, and portal venous gas complicating intragastric balloon placement. Endoscopy 2012;44(S 02):E383—4, http://dx.doi.org/10.1055/s-0032-1310146.
Available online at www.sciencedirect.com
ScienceDirect
Please cite this article in press as: Issa I, et al. Acute pancreatitis caused by intragastric balloon: A case report. Obes Res Clin Pract (2015), http://dx.doi.org/10.1016/j.orcp.2015.08.003
