Stealth Erosion: A Rare Case of Gastric Band Complication 2 Decades Postimplantation With a Prolonged and Complex Hospital Course

A woman in her 60s presented with epigastric pain and fever, initially managed as acute cholecystitis. Imaging was inconclusive, but esophagogastroduodenoscopy on hospital day 4 revealed gastric band erosion 20 years postlaparoscopic adjustable gastric banding. Surgery confirmed partial erosion with abscess along the band tract and subcutaneous port site. Postoperative complications included gastric leak, candida infection, and abdominal wall abscess, managed with antibiotics, drainage, and supportive care. She was later discharged on oral antibiotics but developed a pulmonary embolism requiring anticoagulation. Laparoscopic adjustable gastric banding complications, including erosion, should be considered even decades later; early endoscopy may prevent delays and related complications.