Small bowel ischemia secondary to gastric pacemaker wires—a case report

Gastric stimulator has been used as a surgical option for patients with gastroparesis refractory to medical management. Only one previous report of small bowel gangrene secondary to gastric pacemaker wires has been reported in the literature. Our patient was a 38-year-old woman with a history of systemic lupus erythematosus and history of total colectomy who underwent an uneventful open gastric pacemaker placement for idiopathic gastroparesis. Four months after the initial placement of the pacemaker, she presented to the emergency department with acute abdominal pain and was found to have gangrene of 140 cm of small bowel secondary to looping of gastric pacemaker wires around small bowel mesentery. She underwent uneventful small bowel resection and anastomosis with an ileorectal anastomosis. This case highlights the need for a high index of suspicion for this catastrophic complication in patients with gastric pacemakers.