Polymicrobial bacterial pericarditis and cardiac tamponade caused by pericardial penetration of an adjustable gastric

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Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
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Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

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Ype de Jong1, Rhiannon B van Loenhout2, Dingeman J Swank3

  • 1Department of Internal Medicine, Haaglanden Medical Centrum, The Hague, Netherlands.

BMJ Case Reports
|February 18, 2018
PubMed

Insights

A laparoscopic adjustable gastric band (LAGB) catheter migrated through the liver and diaphragm, causing polymicrobial bacterial pericarditis. Emergency pericardiocentesis and LAGB removal were required to treat the cardiac tamponade.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Cardiology

Background:

  • Laparoscopic adjustable gastric band (LAGB) placement is a common bariatric surgery.
  • Complications, though rare, can be severe.
  • Polymicrobial bacterial pericarditis is an extremely uncommon complication of LAGB.

Observation:

  • A case of polymicrobial bacterial pericarditis involving Klebsiella pneumoniae and Proteus mirabilis is presented.
  • The infection resulted from the migration of an LAGB catheter tip through the liver and diaphragm into the pericardium.
  • The catheter tip was observed in contact with the myocardium, leading to cardiac tamponade.

Findings:

  • Emergency pericardiocentesis was performed to relieve cardiac tamponade.
  • Surgical removal of the LAGB was necessary for patient stabilization.
  • This represents a novel reported complication of LAGB placement.

Implications:

  • Highlights a previously unreported severe complication of LAGB surgery.
  • Emphasizes the importance of vigilant monitoring for migrated device components.
  • Underscores the need for prompt diagnosis and management of infectious complications post-LAGB.
Keywords:
emergency medicinegastroenterologygastrointestinal surgeryinterventional cardiology

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