A rare complication of abdominoplasty after bariatric surgery

We describe an unusual case of small bowel obstruction as a result of an abdominoplasty performed after bariatric surgery. A 40-year-old man presented with signs and symptoms suggestive of small bowel obstruction, 4 years after he underwent a laparoscopic placement of an adjustable gastric band, and 2 years post abdominoplasty following successful weight loss. Investigations confirmed small bowel obstruction while a computed tomography revealed an odd position of the gastric tubing in the abdomen. At laparotomy it was found that the gastric band was in the correct position and still connected by the tubing to the port chamber. However, the port chamber had been moved distally in the anterior abdominal wall as a consequence of the abdominoplasty. As a result of port dislodgement, the tubing had eroded through the small bowel mesentery and created a volvulus leading to small bowel obstruction. During laparotomy the tubing was cut and removed, the band left in position. Postoperative course was uneventful.This case emphasizes the importance of ensuring that the position of the port in the subcutaneous layer of the anterior abdominal wall is maintained while performing an abdominoplasty.