Gastric migration and strangulation after adjustable gastric banding

We present a case of gastric strangulation 6 months after laparoscopic adjustable gastric banding (LAGB). The 45-year-old woman presented to our emergency department with acute left upper quadrant abdominal pain. Initial upper gastrointestinal studies after emergency department presentation showed no flow through the gastric band and an unusual air/fluid level just above the band, not communicating with the proximal pouch. The patient underwent emergency diagnostic laparoscopy, during which strangulation of a portion of the gastric fundus was identified. During this laparoscopic procedure, the band was removed, and the strangulated portion of stomach was resected using a laparoscopic stapling device. The patient had an uneventful postoperative course and was discharged 6 days after surgery. We present this case as an example of a rare late acute complication resulting from LAGB, which should be recognized and treated surgically on an emergent basis.