Goyal Vinay, Elshiekh Mohanad, Drinnon Kyle, Puckett Yanna
Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Department of Thoracic Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
J Surg Case Rep. 2023 Apr 12;2023(4):rjad174. doi: 10.1093/jscr/rjad174. eCollection 2023 Apr.
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.
胃刺激器已被用作药物治疗无效的胃轻瘫患者的一种手术选择。文献中仅报道过1例因胃起搏器导线导致小肠坏疽的病例。我们的患者是一名38岁女性,有系统性红斑狼疮病史和全结肠切除史,因特发性胃轻瘫接受了顺利的开放式胃起搏器植入术。起搏器初次植入4个月后,她因急性腹痛就诊于急诊科,被发现140厘米的小肠发生坏疽,原因是胃起搏器导线环绕小肠系膜形成了肠袢。她接受了顺利的小肠切除及回直肠吻合术。该病例强调了对于植入胃起搏器的患者,需要高度怀疑这种灾难性并发症。