title: Case report: rare case of mechanical bowel obstruction due to strangulation by gastric stimulator electrodes.
abstract: BACKGROUND
  Implantation of a gastric stimulator is a feasible surgical therapy for patients with therapy refractory gastroparesis. In addition it seems to be a promising alternative for treating morbid obesity. We present for the first time the surgical emergency of small bowel obstruction due to strangulation by gastric stimulator electrodes.
  
  
  METHODS
  A 59-year-old Caucasian female had undergone implantation of a gastric stimulator to cope with the symptoms of a partial gastroparesis. Eight years after the operation, the patient began to present repeatedly to different hospitals because of abdominal pain and nausea. Symptoms and imaging indicated ileus, which could always be treated conservatively. The underlying pathology could not ultimately be determined and the symptoms were eventually considered gastroparesis-related. After two years the patient was finally referred in circulatory shock due to peritonitis with underlying small bowel obstruction. Emergency laparotomy revealed small bowel strangulation by the gastric stimulator electrodes.
  
  
  CONCLUSIONS
  Repeated presentation of a patient with an unfamiliar treatment modality must raise suspicion of unusual complications. Specialist surgeons treating with innovative methods should provide proper information that is accessible to everyone who might have to treat possible complications.
authors.affiliation: Department of General Surgery, Torsby Hospital, Värmland County Council, Lasarättsvägen 8, 68529, Torsby, Sweden. hans.lederhuber@liv.se.
authors.forename: Hans
authors.initials: H
authors.lastname: Lederhuber
authors.affiliation: Department of General Surgery, Torsby Hospital, Värmland County Council, Lasarättsvägen 8, 68529, Torsby, Sweden.
authors.forename: Stephan
authors.initials: S
authors.lastname: Axer
authors.affiliation: Department of General Surgery, Torsby Hospital, Värmland County Council, Lasarättsvägen 8, 68529, Torsby, Sweden.
authors.forename: Christof
authors.initials: C
authors.lastname: Ihle
mesh_terms: D004599:Electric Stimulation Therapy / Q000009:adverse effects* / Q000295:instrumentation; D004566:Electrodes / Q000009:adverse effects; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery; D008875:Middle Aged