# Simultaneous Small Bowel Obstruction and Cecal Volvulus From an Internal Hernia Caused by Gastric Band Tubing: A Case Report

## TL;DR

A 43-year-old woman experienced a rare bowel obstruction caused by tubing from a gastric band, which was successfully treated laparoscopically.

## Contribution

This case highlights a rare complication of laparoscopic adjustable gastric bands causing internal hernia and bowel obstruction.

## Key findings

- The gastric band tubing formed a noose causing internal hernia and closed-loop obstruction.
- Laparoscopic lysis of adhesions and transection of the tubing resolved the obstruction.
- The patient recovered well with no long-term complications.

## Abstract

We present a unique case of a 43-year-old woman with a complex bowel obstruction caused by the connecting tubing of a gastric band placed three years prior. The tubing formed a loop with a twist acting as a noose, causing an internal hernia involving the distal ileum. The surrounding adhesions to the transverse colon also caused her mobile cecum to be distended and to be reflected upward. We managed her complex closed-loop bowel obstruction laparoscopically by lysing adhesions and transecting the gastric band tubing. The patient recovered well without sequelae, and the gastric band was later removed by her bariatric surgeon electively. Laparoscopic adjustable gastric band (LAGB) placement used to be one of the most popular forms of bariatric surgery. It is important for abdominal surgeons to be able to recognize various surgical complications of LAGB.