Gastric Electrical Stimulators Causing Erosion Through the Colonic Wall
Sally Condon, MD, Aniruddh Patel, MD, Nihar Shah, MD, et al
ACG Case Rep J. 2020;7:e313
This month's case describes a patient with prior a history of non-healing gastric ulcers treated by the Billroth II procedure, with subsequent Roux-En-Y surgery and vagotomy. He was being treated with a gastric electrical stimulator (GES) for gastroparesis and had required 4 revisions in 8 years, the most recent being a total GES replacement 1 month prior to presentation. He presented with 1 week of abdominal pain, nausea, vomiting, and diarrhea; as well as erythema and purulent discharge at the site of the GES battery pack. A CT scan revealed erosion of the gastric stimulator leads into the colon, and colonoscopy revealed 2 GES wires and a disk-like structure within the distal transverse colon. Patient was successfully treated with systemic antibiotics and surgical removal of the GES. This case highlights a rare but potentially life-threatening complication of the GES. Given that GES use is becoming increasingly popular, awareness of its potential complications is imperative. Careful patient selection after critical consideration of risk factors, with close monitoring of the implanted device is key. This is especially important since the overall benefit of the GES remains inconsistent across clinical studies, and may be limited to only diabetic gastroparesis.
Akshata Moghe, MD
University of Pittsburgh Medical Center
ACG Case Reports Journal