Hematemesis From a Left Gastric Artery Pseudoaneurysm Secondary to an Adjustable Laparoscopic Gastric Band

Eric Downes, Kristen Baker, Jessica L. Buicko, Kandace M. Kichler, Lawrence H. Brickman, Miguel A. Lopez-Viego


Gastric band erosion into the lumen of the stomach or the esophagus is a fairly common but often underreported complication of laparoscopic adjustable gastric banding surgery. It occurs in as many as 3-11% of patients who undergo the procedure. We present here the case of a 56-year-old morbidly obese female who developed the sudden onset of hematemesis and dysphagia more than 3 years after laparoscopic gastric band placement. Endoscopy was performed at presentation and revealed erosion into the proximal gastric lumen. The patient was stabilized with medical management of her anemia and abdominal pain. Both the band and subcutaneous reservoir were subsequently removed laparoscopically. A perforation of the gastric wall was identified and treated with a falciform ligament patch and naso-gastric decompression. Five days after surgical band removal, the patient had an episode of hematemesis productive of over 750 cc of blood, accompanied by tachycardia and hypotension. Mesenteric (celiac artery) angiography revealed an actively bleeding pseudoaneurysm of the left gastric artery that was successfully thrombosed with coils. The patient was kept nil per os (NPO) on total parenteral nutrition (TPN) for 1 week postoperatively and remained stable. A follow-up gastrograffin upper gastrointestinal (GI) study showed no leak from the perforation site. To our knowledge, this is the first reported case in which an erosion from an adjustable laparoscopic gastric band was associated with massive upper GI bleeding from a left gastric artery pseudoaneurysm. The case demonstrates the importance of monitoring a patient with hematemesis post lap band surgery, as life-threatening bleeding may persist after removal of the gastric band.

J Curr Surg. 2014;4(3):95-98
doi: http://dx.doi.org/10.14740/jcs234w


Pseudoaneurysm; Gastric band; Laparoscopy; Bariatric surgery

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics






Journal of Current Surgery, quarterly, ISSN 1927-1298 (print), 1927-1301 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.currentsurgery.org   editorial contact: editor@currentsurgery.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.