Recurrent lung infection after slipped gastric band in a patient with morbid obesity

We report the case of a 43-year-old male with a history of gastroesophageal reflux, obstructive sleep apnea, and morbid obesity who underwent gastric band placement in 2007, with left thoracotomy in 2012 for a loculated empyema. He now presents in acute respiratory distress with fetid-smelling sputum, a leukocytosis of 19.5 K, and a complex left lower lobe lung abscess on imaging. He underwent a redo left thoracotomy, partial rib resection, and drainage/debridement of the lung abscess. Postoperatively, he experienced ongoing poor oral intake due to high-grade stenosis caused by a slipped gastric band, noted on an upper gastrointestinal series. He underwent removal of the gastric band with robotic assistance by the bariatric service and was subsequently discharged after his respiratory status and oral intake improved. Here, we highlight that recurrent lung infections in bariatric surgery patients secondary to chronic reflux and poor dietary compliance mandate long-term surveillance and thorough investigation.