Detachment of the Connecting Tube from the Port and Migration into Jejunal Wall

Abstract

After laparoscopic adjustable gastric banding (LAGB), early recognition and treatment of uncommon complications are important. A 36-year-old man who had undergone LAGB presented at our clinic with weight gain of 14 kg during the prior 6 months. During investigation, detachment of the connecting tube from the port and migration of this tube into the jejunal wall were found. The detached port was replaced with a new port, and laparoscopically-assisted jejunorraphy was performed.

Cecal Volvulus as a Complication of Gastric Banding

“…It was treated by laparotomy and ileal resection with removal of the connecting tubing. Zengin et al [13] reported a case of disconnection of the tubing from the subcutaneous port with subsequent erosion into the jejunal wall in a 36-year-old man post LAGB. Hartmann et al [14] reported colonic perforation by the connecting tube.…”

Presentation and management of port disconnection after laparoscopic adjustable gastric banding

“…Some of these patients underwent investigation for pelvic inflammatory disease, gynecological problems, renal colic, or acute appendicitis. Small-bowel obstruction and migration into jejunal and colonic walls caused by the connecting tube were reported in patients with prolonged abdominal pain [8][9][10][11]. Ability for free food passage and weight gain are other clinical signs of tube disconnection.…”

“…Additional investigations including abdominal plain film, injection of contrast dye through the port, scintigraphy, or abdominal computed tomography (CT) scan can be performed to confirm diagnosis of tube detachment [8,10,11]. In our opinion this is unnecessary.…”

“…Incidence of tube disconnection from access port was reported in 0.45-24% of patients [3][4][5][6][7]. Intractable abdominal pain, small-bowel obstruction, and migration of the tube into jejunal and colonic walls were described as complications of connecting tube disconnection [8][9][10][11]. Early diagnosis and treatment of port disconnection can prevent some of these complications.…”

Perforation of an Adjustable Gastric Banding Connecting Tube into distal Transverse Colon with Intra-luminal Migration

“…Major post-operative complications are uncommon but their occurrence has to be followed by a prompt diagnosis and proper treatment [2][3][4][5][6][7]. These complications can be related either to the port or the connecting tube, such as infection, tube disconnection or dislocation, or to the band, such as band slippage, pouch dilatation, and band erosion [8][9][10][11][12][13][14][15].…”