Contamination of single fluid-filled intragastric balloons with orogastric fluid is not associated with hyperinflation: an ex-vivo study and systematic review of literature

Gastric Perforation Secondary to a Hyperinflated Intragastric Balloon: A Case Report and Management Approach

Intragastric balloon (IGB) placement is a widely used, minimally invasive intervention for obesity and metabolic disorders, offering a temporary, reversible alternative for weight management. It is generally well tolerated, with most complications being mild and self-limiting, such as nausea, vomiting, and abdominal discomfort. However, in rare cases, more serious complications can arise, including gastric ulceration, balloon migration, and, in extreme cases, gastric perforation. The latter can occur at any time from days to months after insertion, necessitating prompt recognition and surgical intervention to prevent life-threatening consequences. We report a case of a 47-year-old woman who presented with an acute abdomen four months after IGB insertion. Imaging revealed a hyperinflated IGB with associated gastric perforation. The patient was urgently taken to the operating room, where an on-table esophagogastroduodenoscopy confirmed the findings. Laparoscopic primary repair was performed following balloon removal. The mechanism behind IGB hyperinflation remains multifactorial. Computed tomography is the preferred imaging modality for diagnosis. In bariatric centers, a minimally invasive approach, combining endoscopic balloon removal with laparoscopic perforation repair, has demonstrated superior outcomes compared to open surgery, reducing morbidity and recovery time. Endoscopic balloon removal combined with laparoscopic repair offers significant advantages, including minimal scarring, faster recovery, and shorter hospital stays. Early detection and a multidisciplinary approach are crucial for optimal patient outcomes.

Spontaneous Intragastric Balloon Hyperinflation: Two Cases and Outcomes

Endoscopic bariatric therapies can provide treatment options for obesity in non-surgical candidates, as a part of combination or serial treatment plans, and for the reduction of obesity-related comorbidities. Several complications of intragastric balloons have been documented, but spontaneous hyperinflation is a risk that has not been well reported previously. We describe two cases of spontaneous intragastric balloon hyperinflation and their outcomes.

Weight Loss Success With Repeat Intragastric Balloon Placement After Hyperinflation and Removal of the Index Balloon

Intragastric balloons are an increasingly common endoscopic alternative to bariatric surgery for the treatment of obesity. Hyperinflation is a rare complication that presents as acute-onset epigastric pain, nausea, vomiting, early satiety, abdominal distention or bloating, and rapid weight loss. Hyperinflation requires prompt diagnosis and removal of the balloon to prevent complications including gastric outlet obstruction or gastric perforation. We present a case of intragastric balloon hyperinflation with removal of the index device, followed by replacement with a second balloon, resulting in continued weight loss without further adverse events.

Mixed Fungal Biofilms: From Mycobiota to Devices, a New Challenge on Clinical Practice

Most current protocols for the diagnosis of fungal infections are based on culture-dependent methods that allow the evaluation of fungal morphology and the identification of the etiologic agent of mycosis. Most current protocols for the diagnosis of fungal infections are based on culture-dependent methods that enable the examination of the fungi for further identification of the etiological agent of the mycosis. The isolation of fungi from pure cultures is typically recommended, as when more than one species is identified, the second agent is considered a contaminant. Fungi mostly survive in highly organized communities that provoke changes in phenotypic profile, increase resistance to antifungals and environmental stresses, and facilitate evasion from the immune system. Mixed fungal biofilms (MFB) harbor more than one fungal species, wherein exchange can occur that potentialize the effects of these virulence factors. However, little is known about MFB and their role in infectious processes, particularly in terms of how each species may synergistically contribute to the pathogenesis. Here, we review fungi present in MFB that are commensals of the human body, forming the mycobiota, and how their participation in MFB affects the maintenance of homeostasis. In addition, we discuss how MFB are formed on both biotic and abiotic surfaces, thus being a significant reservoir of microorganisms that have already been associated in infectious processes of high morbidity and mortality.