J Gastroenterol Hepatol Endosc | Volume 2, Issue 6 | Case Report | Open Access
Ernesto Licon1, Irene Sarosiek2, Brian R. Davis2 and Richard W McCallum2*
1Department of Gastroenterology, Texas A&M Health Science Center College of Medicine, Dallas, USA
2Department of Gastroenterology, Texas Tech University Health Sciences Center, El Paso, USA
*Correspondance to: Richard W McCallum
Fulltext PDFBackground: Treatment of drug-refractory gastroparesis (GP) may include gastric electrical stimulation (GES) accompanied by Pyloroplasty. This approach has been shown to improve gastric emptying and reduce symptoms up to 80%. One must be aware of the important although rare complication of perforation of the gastric leads through the gastric mucosa into the lumen during long-term follow up of the GES patients.
Case Report: Two recent cases represent the significant recurrence of symptoms in GP patients, while interrogation of the GES system did not display abnormal readings of any parameters, with special focus on potential changes of the impedance, representing resistance between the electrodes, implanted 1 cm apart. Upon further evaluation via upper endoscopy, it was confirmed that there was perforation of electrodes through the gastric mucosa into the gastric lumen in both patients requiring surgical intervention to remove the electrodes and stimulator.
Conclusion: Impedance does not necessarily change to abnormal values when perforation of electrodes through the gastric mucosa occurs in patients with GES devices, suggesting that impedance may not serve as a predictor of luminal perforation. However, worsening symptom control does seem to correlate with perforation of electrodes.
Gastroparesis; Gastric electrical stimulation; Pyloroplasty; Complications; Perforation
Licon E, Sarosiek I, Davis BR, McCallum RW. Adventures in GI Motility: Reminders of the Complications of Gastric Electrical Stimulator Implantation. J Gastroenterol Hepatol Endosc. 2017;2(6):1030.