1010 Endo Poster SMALL BOWEL OBSTRUCTION CAUSED BY THE TUBING SYSTEM AFTER LAGB Ronit Grinbaum, Nurith Hiller *, Haggi Mazeh, Herbert R. Freund, Mahmud Baddariah, Nahum Beglaibter Department of Surgery and Radiology*, Hadassah University Hospital, Mount Scopus Jerusalem Introduction: we recently encountered a rare and to the best of our knowledge non-reported complication of small bowel obstruction caused by the tubing system of a Laparoscopic Band (LAGB). Case report: A 45 year-old female patient was admitted with abdominal pain and vomiting which began on the day of admission. Past history included SRVG in 1998, laparoscopic cholecystectomy in 1999 followed by appendectomy and hysterectomy. Due to recurrent vomiting, dysphagia and total food intolerance she underwent gastro-gastrostomy and adjustable gastric band placement in 2000. Physical examination on admission was remarkable for soft, slightly distended abdomen with epigastric tenderness, no peritoneal signs. Abdominal plain film showed distended small bowel loops with air fluid levels. An UGI series showed the band in normal position with no sign of obstruction at the level of the band. Abdominal CT demonstrated small bowel obstruction with looping of the band tube around a jejunal loop with consequent obstruction. At laparoscopic exploration, multiple adhesions were encountered but the obstruction was clearly caused by the tube which crossed the meso of the trapped loop forming a tight chronic stricture. The tubing was cut to release the obstruction and a mini laparotomy was done to repair the tubing and replace the access port. The patient did well and was discharged on post operative day 3. Conclusion: intestinal obstruction due to the tubing system is one more cause to be considered in the differential diagnosis of intestinal obstruction in patients who underwent LAGB.