Life-threatening late complication after laparoscopic adjustable gastric banding: two cases of gastric necrosis Eun Young Kim, M.D., Yong Jin Kim, M.D.,

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Life-threatening late complication after laparoscopic adjustable gastric banding: two cases of gastric necrosis Eun Young Kim, M.D., Yong Jin Kim, M.D., Ph.D. Surgery for Obesity and Related Diseases Volume 12, Issue 1, Pages e5-e9 (January 2016) DOI: 10.1016/j.soard.2015.07.018 Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions

Fig. 1 (A) Gastroduodenoscopy reveals mucosal necrosis of the gastric upper body. (B) Computed tomography was done after the gastroduodenoscopy. As a result, computed tomography showed marked distention of the stomach with decreased wall enhancement. (C) On plain radiograph there is marked distention of the stomach, but the gastric band is positioned correctly. Surgery for Obesity and Related Diseases 2016 12, e5-e9DOI: (10.1016/j.soard.2015.07.018) Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions

Fig. 2 (A) Computed tomography shows decreased wall enhancement and an intramural air density along the gastric wall. The arrows indicated the gastric pneumatosis. (B) On plain radiograph the gastric band is oriented correctly but has shifted to the right of the midline because of gastric distention; an air density is seen over the gastric wall. It is marked by the arrows. Surgery for Obesity and Related Diseases 2016 12, e5-e9DOI: (10.1016/j.soard.2015.07.018) Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions

Fig. 3 (A) Mucosal (left) and serosal (right) sides of the stomach in the patient described in case 1. The gastric wall shows segmental black discoloration and edema because of transmural infarction and necrosis with inflammation. (B) Mucosal (left) and serosal (right) sides of the stomach in the patient described in case 2. The gastric wall is thickened and necrotized by edema and transmural hemorrhagic infarction. Surgery for Obesity and Related Diseases 2016 12, e5-e9DOI: (10.1016/j.soard.2015.07.018) Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions