Gastric Perforation following Intragastric Balloon Insertion: Combined Endoscopic and Laparoscopic Approach for Management: Case Series and Review of Literature

Background Obesity is a serious disease, with substantial morbidity and mortality. The endoscopic placement of an intragastric balloon (IGB) in association with a low-calorie diet is an option for the treatment of obesity. IGB complications include dislocation of the balloon causing intestinal obstruction, upper gastro-intestinal bleeding and perforation, especially during balloon insertion or removal. Our work aims at decreasing the morbidity of open laparotomy in the management of such gastric perforations. Methods We report three cases of gastric perforation following IGB insertion that needed surgical intervention. Decision was made to treat them with a minimally invasive combined endoscopic and laparoscopic approach to decrease postoperative morbidity. Results All patients were successfully treated by a minimally invasive approach with less morbidity than the conventional open laparotomy. Conclusion Gastric perforation should be suspected in any patient with IGB who presents with an acute abdomen. This can be managed with a minimal invasive approach.