Background

Introduction: Laparoscopic adjustable gastric banding (LAGB) has declined in popularity since its peak around 2008. Erosion of the band into nearby structures is a well-known complication with incidence in one study of 301 patients reported as 1.66%. However, in another report of 950 patients, band erosion developed in only 0.31% of patients by 6-8 months. Despite variation in reported incidence, it is clear that this complication is uncommon. There has been documentation of band erosion into the stomach, the esophagus, and the colon with variations in clinical presentation. While patients have been reported to present with port site cellulitis/abscess and abdominal pain, there are very few documented cases of erosion of the gastric band into the stomach presenting as an abdominal wall abscess. Case Presentation: Here, we present a case of LAGB erosion presenting as an abdominal wall abscess. The patient is a 51-year-old male who presented to the emergency department with a complaint of a non-healing wound in the left upper quadrant. Prior to presentation, he completed a 10-day course of PO Augmentin followed by 14 days of PO Doxycycline. The patient initially “felt a pop” at the port site, followed by drainage. CT imaging showed fat stranding surrounding the port site, as well as extension into the perigastric fat, suggestive of direct extension of infectious process into the peritoneum. The patient was subsequently taken to the operating room for laparoscopic band removal and partial gastrectomy. Discussion: This case illustrates prompt diagnosis and treatment of occult gastric band erosion.