Difficult explant of intragastric balloon with severe fungal colonization: How do I do it? / Retirada difícil del balón intragástrico con colonización fúngica grave: ¿cómo lo hago?

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Retirada difícil del balón intragástrico con colonización fúngica grave: ¿cómo lo hago? Respuesta-comentario del Grupo Español de Endoscopia Bariátrica / Difficult explant of intragastric balloon with severe fungal colonization: How do I do it? Response-commentary of the Spanish Bariatric Endoscopy Group

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Candida albicans colonization on an intragastric balloon.

Here we present the case of Candida albicans colonization on an intragastric balloon placed for weight loss. A 52-year-old obese woman achieved a BMI reduction of 10.9 kg/m(2) within 7 months as a result of a BioEnterics Intragastric Balloon and a well-balanced, low-calorie diet. During endoscopy for balloon removal, the balloon, which was well impacted in the gastric fundus, was found to be lime green in color with clusters of cone-shaped cultures on its surface. Microbiology assessment revealed the presence of Candida albicans, although the patient was totally asymptomatic.

A case of asymptomatic fungal and bacterial colonization of an intragastric balloon.

Intragastric balloon therapy, as a part of a multidisciplinary weight management program, is an effective short-term intervention for weight loss. Although the insertion procedure is easy and generally well tolerated by patients, a few complications can occur. We report here a heavy smoker with intragastric balloon insertion complicated by colonization with opportunistic organisms. The 27-year-old female, body mass index 35.5 kg/m(2), had a BioEnterics Intragastric Balloon inserted under conscious sedation without any perioperative complications. Six months later, when the standard removal time arrived, the balloon was seen to be covered with a necrotic white-gray material. Microbiological examination revealed Enterobacter cloacae and Candida species yeast colonies. We recommend that asymptomatic fungal and/or bacterial colonization should be considered among the complications of the intragastric balloon procedure, despite its rarity.