Background

Intragastric balloon placement is one of the FDA approved endoscopic bariatric therapies. Intragastric balloon induced pancreatitis (BIP) is an extremely rare complication. It occurs either due to extrinsic compression of the pancreas (compressive balloon pancreatitis), or due to obstruction of the ampulla following balloon partial deflation and migration (obstructive balloon pancreatitis). Our aim was to identify the causes and the outcomes of this adverse event.

Methods

A literature review was performed in Cochrane Database, Embase, Medline, PubMed, and Scopus electronic databases using terms 'intragastric balloon' and 'pancreatitis' to identify pertinent articles. The initial search yielded 437 studies which were manually reviewed, and 24 studies met the inclusion criteria.

Results

A total of 40 patients were reported in the literature. The mean age was 30 years old with females representing 68%. Pancreatitis occurred after a mean of 96 days of balloon placement. Pancreatitis was mild, moderate, and severe in 58%, 35% and 7% respectively. Most of the cases (90%) were compressive pancreatitis. Mean volume of fluid inside the balloon was 575 ml. Early balloon removal was needed in 79% of the cases whereas conservative management was adequate in the rest.

Conclusions

Intragastric balloon induced pancreatitis is an extremely rare adverse event that can occur while using the recommended balloon's fluid volume and placement duration. Fortunately, most cases are mild but necessitated early balloon removal. Further research is needed to identify the risk factors and the possible ways of conservative management to avoid early removal.