Bowel Obstruction Caused by Migration of an Intra-Gastric Balloon: A Rare Case Treated Laparoscopically

BACKGROUND Endoscopic bariatric therapies, such as intra-gastric balloons (IGB) offer a less invasive, efficacious, and safe approach to facilitate weight loss in obese individuals. While typically tolerated, rare complications, including intestinal migration of the IGB, can occur and lead to serious sequelae such as mechanical bowel obstruction. This case report details the diagnostic process and successful laparoscopic surgical management of an unusual instance of IGB migration resulting in small bowel obstruction. CASE REPORT We present the case of a 32-year-old woman who developed a small bowel obstruction 1 month following IGB insertion for weight management. Her initial postoperative course was complicated by persistent nausea and vomiting, which progressed to generalized abdominal pain and constipation. A contrast-enhanced computed tomography scan confirmed the diagnosis of a distal small bowel obstruction caused by a deflated and migrated IGB. The patient underwent successful laparoscopic exploration and retrieval of the balloon, followed by an uncomplicated postoperative recovery and discharge by postoperative day 5. Long-term follow-up revealed complete resolution of symptoms and a return to normal bowel function. CONCLUSIONS This case highlights the need for clinicians to maintain a high index of suspicion for rare events such as balloon migration in patients presenting with gastrointestinal symptoms following IGB insertion. Furthermore, it demonstrates that laparoscopic retrieval is a feasible, safe, and potentially advantageous management approach for migrated IGBs causing small bowel obstruction, potentially offering better outcomes compared to open surgery. Further research is needed to refine management guidelines across various IGB types and failure modes.