As more and more people opt for gastric band surgery to lose weight, the more people will experience complications linked to the procedure. In a case report published Online First in The Lancet, Dr. Adam Czapran at the Department of Respiratory Medicine and Coronary Care Unit at Russells Hall Hospital in Dudley, West Midlands, UK, and his team describe a 49-year old woman's ordeal several years after she had gastric band surgery.
The woman came to the hospital's outpatient clinic in May 2010. She had a 4-month history of night sweats as well as a continuous productive cough with green and yellow sputum. According to her medical history, she suffered from asthma that had been unresponsive to treatment, and she had laproscopic adjustable gastric band surgery in September 2008.
The surgery decreased her body-mass index (BMI) from 45 at the time of surgery to 33 in May 2010. Doctors performed a chest radiograph, which revealed a cavity within the left upper zone. Based on this, in combination with her night sweats, doctors suspected that the woman was suffering from tuberculosis, yet consistently negative test results eliminated this diagnosis.
After performing further tests, they suspected that the problems could be associated with her gastric band, whereby recurrent aspiration of ingested food caused reflux down her windpipe, leading to subsequent lung damage as well as cavitation, a formation of holes in the lung often caused by infection, secondary to the gastric band fitting. A course of antibiotics only offered limited relief. The patient had lost a significant amount of weight following her gastric band surgery. However, as her symptoms persisted, a medical team completely withdrew the fluid from (or 'emptied') her gastric band, after which the woman's symptoms quickly resolved.
In May 2011, at the woman's last follow-up, her BMI measured 35 and her gastric band had been cautiously refilled with no symptom recurrence.
The researchers state that lung-related problems, such as the one described above, are rare. The most common complications of gastric band surgery are erosion or slipping of the band.
They conclude saying:
"These late pulmonary complications can present with asthma-like symptoms and can be misdiagnosed if not properly investigated. Patients who have undergone laparoscopic adjustable gastric banding should have chest radiography or thoracic CT scan, or both, if they present with respiratory symptoms.
Withdrawal of the fluid from the band should be done as soon as possible to relieve the obstruction. Given the increasing frequency of people undergoing interventional procedures to aid weight loss, recognition of the short-term and long-term complications is paramount."
Written by Petra Rattue