Small bowel obstruction due to Garren gastric bubble: Radiographic diagnosis

The Garren (Garren-Edwards) gastric bubble (American Edwards, Irvine, CA) has been used in more than 20,000 patients for the treatment of morbid obesity. The efficacy of this device as an adjunct to weight loss has been questioned, yet it remains widely used along with a variety of similar devices being evaluated by the U.S. Food and Drug Administration. The most significant complication associated with use of the Garren bubble is bowel obstruction due to spontaneous deflation with passage of the bubble into the small bowel. Although small bowel obstruction due to the Garren-Edwards balloon has been previously described, the characteristic plain film findings have not been described. The plain radiographs of two patients with small bowel obstruction resulting from deflated Garren gastric bubbles are reported. In vitro studies were also performed to clarify the radiographic appearance of the deflated bubble.