A case report of severe gastric erosions, ulceration, and bleeding following intragastric balloon placement for weight loss

Intragastric balloon (IGB) therapy has been increasingly used as minimally invasive procedure for obesity management, offering short-term weight loss benefits with a favorable safety profile. However, serious complications such as gastric erosions and upper gastrointestinal (UGI) bleeding, though rare, can occur and require urgent intervention. We report a rare case of severe UGI bleeding in a 36-year-old female following IGB insertion for weight loss. She presented to the emergency department with symptoms of upper gastrointestinal bleed and significant anemia (hemoglobin 68 g/L) ten days post-intragastric balloon insertion at private hospital in Sydney. Computed tomography imaging confirmed an intact gastric balloon without signs of gastric perforation. Emergency gastroscopy and early balloon removal were done without complication. Also, multiple gastric erosions were seen on the first gastroscopy. Despite initial stabilization, the patient had recurrent bleeding, necessitating two additional endoscopies to achieve hemostasis. This case highlights a rare but serious complication of IGB therapy. Delayed presentation contributed to the severity of bleeding. Intragastric balloon-related complications underscore the importance of careful patient selection, prophylactic proton pump inhibitor use, timely symptom recognition, and close post-procedure monitoring. Though IGBs are generally safe, clinicians must remain vigilant for rare but serious adverse events like UGI bleeding.