Houssein Chebbo¹, Sarah Saleh¹, Karam Karam², Sarah Jalloul², Johny Salem³, Georges El Hashem⁴, Elias Saikaly⁵, Charbel Fares⁶, Marwan Haddad⁶, Pierre Hani⁷ and Elias Fiani⁷

¹Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
²Department of Gastroenterology, Faculty of Medicine, University of Balamand, Delweneh-Beirut, Lebanon
³Department of Internal Medicine, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
⁴Associate Professor of Clinical Medicine in Hematology and Oncology, Faculty of Medicine, Saint George University of Beirut
⁵Associate Professor, Department of General Surgery, Faculty of Medicine, University of Balamand, Dekweneh, Lebanon
⁶Associate Professor, Department of Radiology, Faculty of Medicine, University of Balamand, Dekweneh, Lebanon
⁷Associate professor, Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon

*Corresponding Author: Elias Fiani, Associate professor, Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon.

Received: May 24, 2024; Published: June 13, 2024

Abstract

Background: Introduction: Bariatric surgery is a frequently used method for weight loss in obese patients. However, there has been a rising preference for non-surgical techniques like intragastric balloons (IGBs), where a balloon is endoscopically placed in the stomach and then filled with fluid. Pancreatitis is a rare and serious complication of IGBs, recognized by the FDA in February 2017. We report one such instance of pancreatitis in a Lebanese female with an IGB inserted several months ago.

Case: A 55-year-old female patient with no chronic illness presented to the emergency department with nausea and acute epigastric pain radiating to the back. History goes back to six months ago, when the patient underwent an intragastric balloon placement procedure for weight loss. Laboratory workup of liver function enzymes, triglycerides, bilirubin, and CRP was normal except for a staggering elevation in pancreatic enzyme levels, with a lipase value of 3000 U/L (reference range is 10–40 U/L) and serum amylase of 1000 U/L (reference range is 40–140 U/L). Those findings are consistent with a diagnosis of acute pancreatitis.

Discussion: The most common endoscopic therapy for obesity is intragastric balloon insertion. It is recommended to keep the balloon in the stomach for no longer than 6 months to decrease the possibility of complications. The concept behind the use of IGB is to act as a physical impediment for food, thus reducing gastric capacity and delaying gastric emptying. Of the rare complications of IGBs, pancreatitis is among the most prevalent but not the most threatening. Patients are susceptible to pancreatitis at any point in time after the procedure, starting on day 1 up until 11 months after insertion. The most likely cause of pancreatitis in IGB cases appears to be stomach dilation, which compresses the pancreatic tail and body.

Conclusion: Obesity is a metabolic disorder resulting from increased body fat. Several treatments are available, including intragastric balloon placement. Pancreatitis seems to be a rare but serious complication of the procedure. Further research is needed to minimize any possible complications of weight loss procedures.

Keywords: Intragastric Balloon Insertion; Pancreatitis; Obesity

References

1. Al Refai F., et al. “Acute Pancreatitis Secondary to Intragastric Balloon: A Case Report and Literature Review”. Cureus 9 (2023): e45230.
2. Said F., et al. “Pancreatitis and intragastric balloon insertion”. Surgery for Obesity and Related Diseases 3 (2016): e33-e34.
3. Aljiffry M., et al. “Acute Pancreatitis: A Complication of Intragastric Balloon”. Surgical Laparoscopy, Endoscopy and Percutaneous Techniques6 (2017): 456-459.
4. Kim SH., et al. “Current status of intragastric balloon for obesity treatment”. World Journal of Gastroenterology24 (2016): 5495-504.
5. Purnell JQ. “Definitions, Classification, and Epidemiology of Obesity”. 2023 May 4. In: Feingold KR., et al. “editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc (2000).
6. Bischoff SC and Schweinlin A. “Obesity therapy”. Clinical Nutrition ESPEN 38 (2020): 9-18.
7. Perdomo CM., et al. “Contemporary medical, device, and surgical therapies for obesity in adults”. Lancet10382 (2023): 1116-1130.
8. Henao Carrillo DC., et al. “Factors associated with different patterns of weight change after bariatric surgery: A longitudinal study”. Obesity Science and Practice 5 (2023): 477-483.
9. Yorke E., et al. “Intragastric Balloon for Management of Severe Obesity: a Systematic Review”. Obesity Surgery 9 (2016): 2248-2254.
10. Alqabandi O., et al. “Intragastric balloon insertion and pancreatitis: Case series”. International Journal of Surgery Case Reports 74 (2020): 263-267.
11. Mathus-Vliegen EM. “Endoscopic treatment: the past, the present and the future”. Best Practice and Research Clinical Gastroenterology 4 (2014): 685-702.
12. Stavrou G., et al. “Life-threatening visceral complications after intragastric balloon insertion: Is the device, the patient or the doctor to blame?” Endoscopy International Open 2 (2019): E122-E129.
13. Akiki L and Alomary A. “Acute Pancreatitis as a Complication of an Intragastric Balloon”. Cureus 4 (2023): e38094.
14. Gore N., et al. “Pancreatitis from intra-gastric balloon insertion: Case report and literature review”. International Journal of Surgery Case Reports 45 (2018): 79-82.
15. Alkhathami AA., et al. “Acute pancreatitis after intragastric balloon insertion: case report”. Journal of Surgical Case Reports 5 (2023): rjad265.
16. Koo BC., et al. “Imaging acute pancreatitis”. British Journal of Radiology 986 (2010): 104-112.
17. Abdulghaffar S., et al. “Acute pancreatitis as a late complication of intra-gastric balloon insertion”. Journal of Surgical Case Reports 4 (2021): rjab139.v

Citation

Citation: Elias Fiani., et al. “Pancreatitis 6 Months After Intragastric Balloon Insertion". Acta Scientific Gastrointestinal Disorders 7.7 (2024): 30-33.

Copyright

Copyright: © 2024 Elias Fiani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.