Commentary

Intragastric balloons (IGBs) are effective in inducing weight loss, but severe adverse events, such as small-bowel obstruction, stomach perforation or tears, and bleeding, may occur.

In early 2017, the U.S. Food and Drug Administration (FDA) alerted those working in the bariatrics field about potential risks with liquid-filled IGBs, one of the risks being that the liquid-filled IGB overinflates with air or with more liquid in patients’ stomachs, resulting in the need for premature removal of the device [1].

Spontaneous hyperinflation causes abdominal swelling and pain, and/or vomiting, as in this case. It is speculated that it may be caused by permeability of the IGB, with entry of fluids and gases by osmosis, or by bacteria or fungi, such as Candida parapsilosis in this case, which, in high saline concentrations, produce gas by fermentation.

Treatment of spontaneous hyperinflation is relatively simple by puncturing the IGB, which will resolve the symptoms provided no irreversible ischemia is present.

Publication History

Article published online:
22 April 2020

• Reference

• 1 U.S. Food and Drug Administration (FDA). The FDA alerts health care providers about potential risks with liquid-filled intragastric balloons. https://www.fda.gov/medical-devices/letters-health-care-providers/fda-alerts-health-care-providers-about-potential-risks-liquid-filled-intragastric-balloons