{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:13:21Z","timestamp":1783660401929,"version":"3.55.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Swallowable intragastric balloon is a minimally invasive bariatric option for obesity, but severe intolerance requiring intervention is uncommon. We report a 41-year-old man with grade I obesity, hypertension, dyslipidemia, and hyperthyroidism who developed severe retrosternal pain, reflux, persistent vomiting, and oral intolerance 5\u00a0days after balloon placement. Computed tomography showed appropriate balloon position without migration or perforation but suggested a small hiatal hernia. Due to refractory symptoms, laparoscopic balloon removal was performed. Intraoperative findings revealed a larger hiatal hernia with paraesophageal lipoma than previously identified, prompting simultaneous hiatoplasty and conversion to Roux-en-Y gastric bypass. The patient had progressive postoperative recovery with symptom resolution and improved oral tolerance. This case highlights that severe balloon intolerance may reveal occult hiatal pathology despite inconclusive preoperative studies and demonstrates that single-stage laparoscopic balloon removal, hiatal hernia repair, and definitive bariatric surgery can be a safe, effective strategy in appropriately selected patients.<\/jats:p>","DOI":"10.1093\/jscr\/rjag564","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:17:51Z","timestamp":1783657071000},"source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic removal of swallowable intragastric balloon and conversion to Roux-en-Y gastric bypass with concurrent hiatoplasty: a case report"],"prefix":"10.1093","volume":"2026","author":[{"given":"Tabata L","family":"Tinoco Ortiz","sequence":"first","affiliation":[{"name":"Hospital Metropolitano de Quito, Department of Surgery , Av. Mariana de Jes\u00fas s\/n & Av. Occidental (Calle B, N31-190), 170521, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximo V","family":"Torres Guaicha","sequence":"additional","affiliation":[{"name":"Hospital Metropolitano de Quito, Department of Surgery , Av. Mariana de Jes\u00fas s\/n & Av. Occidental (Calle B, N31-190), 170521, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M","family":"Tovar-Cobos","sequence":"additional","affiliation":[{"name":"Universidad San Francisco de Quito, School of Medicine , Av. Diego de Robles & Av. Oswaldo Guayasam\u00edn, 170901, Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"2026071000174599900_ref1","doi-asserted-by":"publisher","first-page":"3591","DOI":"10.1007\/s11695-025-08074-2","article-title":"Weight loss maintenance 1 year after the swallowable gastric balloon: results from an international multicenter study","volume":"35","author":"Caballero","year":"2025","journal-title":"Obes Surg"},{"key":"2026071000174599900_ref2","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.1053\/j.gastro.2021.03.003","article-title":"AGA clinical practice guidelines on Intragastric balloons in the management of obesity","volume":"160","author":"Muniraj","year":"2021","journal-title":"Gastroenterology"},{"key":"2026071000174599900_ref3","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1053\/j.gastro.2017.01.035","article-title":"Clinical practice update: expert review on endoscopic bariatric therapies","volume":"152","author":"Abu Dayyeh","year":"2017","journal-title":"Gastroenterology"},{"key":"2026071000174599900_ref4","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1007\/s11695-007-9110-6","article-title":"New technique for endoscopic removal of Intragastric balloon placed for treatment of morbid obesity","volume":"17","author":"Galloro","year":"2007","journal-title":"Obes Surg"},{"key":"2026071000174599900_ref5","doi-asserted-by":"publisher","first-page":"2718","DOI":"10.1007\/s11695-023-06716-x","article-title":"Surgical management of intra-gastric balloon complications, single-center experience, and literature review","volume":"33","author":"Foula","year":"2023","journal-title":"Obes Surg"},{"key":"2026071000174599900_ref6","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.14309\/ajg.0000000000000734","article-title":"ACG clinical guidelines: clinical use of esophageal physiologic testing","volume":"115","author":"Gyawali","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"2026071000174599900_ref7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/jgh.14758","article-title":"Diagnostic value of X-ray, endoscopy, and high-resolution manometry for hiatal hernia: a systematic review and meta-analysis","volume":"35","author":"Li","year":"2020","journal-title":"J Gastro Hepatol"},{"key":"2026071000174599900_ref8","doi-asserted-by":"publisher","first-page":"S330","DOI":"10.1016\/j.jacr.2021.08.006","article-title":"ACR appropriateness criteria\u00ae epigastric pain","volume":"18","author":"Vij","year":"2021","journal-title":"J Am Coll Radiol"},{"key":"2026071000174599900_ref9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11695-022-06332-1","article-title":"2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) indications for metabolic and bariatric surgery","volume":"33","author":"Eisenberg","year":"2023","journal-title":"Obes Surg"},{"key":"2026071000174599900_ref10","doi-asserted-by":"publisher","first-page":"5791","DOI":"10.1007\/s00464-023-10202-x","article-title":"Endoscopic plication compared to laparoscopic fundoplication in the treatment of gastroesophageal reflux disease: a systematic review and meta-analysis","volume":"37","author":"Hajjar","year":"2023","journal-title":"Surg Endosc"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/7\/rjag564\/68741732\/rjag564.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/7\/rjag564\/68741732\/rjag564.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:17:51Z","timestamp":1783657071000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag564\/8729455"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag564","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"rjag564"}}