Small Bowel Obstruction Secondary to Coiling of Gastric Electrical Stimulator Leads: A Rare Complication of Gastroparesis Management

Gastroparesis is a syndrome marked by delayed gastric emptying without mechanical obstruction, and surgical interventions such as gastric electrical stimulation (GES) are typically considered after conservative treatments fail. We present the case of a 53-year-old woman with idiopathic gastroparesis who had undergone GES placement 13 years prior and presented with three days of nausea, vomiting, and abdominal pain. CT imaging revealed a high-grade mechanical small bowel obstruction due to interval coiling and migration of the GES leads, which was confirmed intraoperatively; the patient underwent enterolysis, lead explantation, and placement of a new GES system. This case highlights a rare but serious complication of GES, with only three similar cases previously reported, and underscores the importance of recognizing lead migration as a potential cause of bowel obstruction. Clinicians, especially radiologists and surgeons, should closely assess for changes in lead position on imaging in symptomatic patients with implanted devices, as early diagnosis and intervention are critical to preventing severe outcomes such as bowel ischemia.