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Figure it out fridays 


A 37-year-old woman was admitted to our emergency department with acute onset of abdominal pain, vomiting, and dyspnea. Six months earlier, she had undergone laparoscopic adjustable gastric banding for severe obesity. Physical examination now showed an anxious, dyspneic woman with a respiratory rate of 45 per minute. There was a tachycardia (140/minute) and blood pressure difference between the left (60/40 mmHg) and the right arm (110/70 mmHg). Auscultation of the chest revealed diminished breathing sounds on the left side. 

After a nasogastric tube was inserted, the patient was intubated because of respiratory insufficiency. A computed tomography (CT) and Chest x-ray were performed.

What is the most likely diagnosis?



A. Band slippage

B. Gastric perforation 

D. Pouch dilation

E. Gastric erosion

F. Hiatal Hernia

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