Surgery for Obesity and Related Diseases 9 (2013) e63–e65 Case report Gastric obstruction due to adhesions 3 months after removal of an adjustable gastric band Radwan Kassir, M.D. a , Pierre Blanc, M.D. b, * , Christophe Breton, M.D. b a Department of Digestive Surgery, CHU Hospital, Jean Monnet University, Saint Etienne, France b Department of Digestive Surgery, Clinique Chirurgicale Mutualiste, Saint Etienne, France Received January 2, 2013; accepted March 15, 2013 Laparoscopic adjustable gastric banding (LAGB) is a frequently used surgical procedure for the treatment of morbid obesity [1]. Several complications of LAGB have been described; however, gastric obstruction, as a compli- cation of LAGB, has been only rarely reported [2–4]. We report the case of gastric obstruction caused by adhesions 3 months after the removal of the gastric band Case report A 38-year-old woman was suffering from aphagia. Four years previously, she had a LAGB inserted for a body mass index (of 40 kg/m 2 (pars flaccida technique, with the band fixed with stitches). Two years after LAGB, she presented with dysphagia and dilation of the proximal gastric pouch. Hence, the gastric banding was completely deflated. Despite this procedure, the patient still complained of dysphagia. The gastric band was removed laparoscopically: the fibrous capsule surrounding the gastric band was incised and the stitches divided with the aim of releasing the wrap. Three months after the removal of the gastric band, the patient was admitted emergently with aphagia. A contrast swallow was performed and showed a complete stomach obstruction (Fig. 1). An endoscopic dilation was unsuccessful. She underwent laparoscopic exploration, which found an adhesive compression of the stomach. There was a large band of tissue between the lesser and greater curvatures of the stomach (Fig. 2) with an anterior gastric prolapse without necrosis (Fig. 3). This adhesion was removed with hook cautery. A Gastrografin swallow was performed on the first postoperative day, which documented absence of the obstruction (Fig. 4). Her postoperative evolution course was uneventful and the patient was discharged from the hospital after 2 days. Fig. 1. An emergency contrast swallow showed a stomach stenosis. 1550-7289/13/$ – see front matter r 2013 American Society for Metabolic and Bariatric Surgery. All rights reserved. http://dx.doi.org/10.1016/j.soard.2013.03.004 * Correspondence: Pierre Blanc, M.D., Clinique Chirurgicale Mutua- liste, 3 rue le Verrier, BP 209, 42013 Saint Etienne, France. E-mail: pblanc@mutualite-loire.com